TY - JOUR
T1 - An eicosapentaenoic acid supplement versus megestrol acetate versus both for patients with cancer-associated wasting
T2 - A North Central Cancer Treatment Group and National Cancer Institute of Canada collaborative effort
AU - Jatoi, Aminah
AU - Rowland, Kendrith
AU - Loprinzi, Charles L.
AU - Sloan, Jeff A.
AU - Dakhil, Shaker R.
AU - MacDonald, Neil
AU - Gagnon, Bruno
AU - Novotny, Paul J.
AU - Mailliard, James A.
AU - Bushey, Teresita I.L.
AU - Nair, Suresh
AU - Christensen, Brad
PY - 2004
Y1 - 2004
N2 - Purpose: Studies suggest eicosapentaenoic acid (EPA), an omega-3 fatty acid, augments weight, appetite, and survival in cancer-associated wasting. This study determined whether an EPA supplement - administered alone or with megestrol acetate (MA) - was more effective than MA. Patients and Methods: Four hundred twenty-one assessable patients with cancer-associated wasting were randomly assigned to an EPA supplement 1.09 g administered bid plus placebo; MA liquid suspension 600 mg/d plus an isocaloric, isonitrogenous supplement administered twice a day; or both. Eligible patients reported a 5-lb, 2-month weight loss and/or intake of less than 20 calories/kg/d. Results: A smaller percentage taking the EPA supplement gained ≥ 10% of baseline weight compared with those taking MA: 6% v 18%, respectively (P = .004). Combination therapy resulted in weight gain of ≥ 10% in 11% of patients (P = .17 across all arms). The percentage of patients with appetite improvement (North Central Cancer Treatment Group Questionnaire) was not statistically different: 63%, 69%, and 66%, in EPA-, MA-, and combination-treated arms, respectively (P = .69). In contrast, 4-week Functional Assessment of Anorexia/Cachexia Therapy scores suggested MA-containing arms experienced superior appetite stimulation compared with the EPA arm, with scores of 40, 55, and 55 in EPA-, MA-, and combination-treated arms, respectively (P = .004). Survival was not significantly different among arms. Global quality of life was not significantly different among groups. With the exception of increased impotence in MA-treated patients, toxicity was comparable. Conclusion: This EPA supplement, either alone or in combination with MA, does not improve weight or appetite better than MA alone.
AB - Purpose: Studies suggest eicosapentaenoic acid (EPA), an omega-3 fatty acid, augments weight, appetite, and survival in cancer-associated wasting. This study determined whether an EPA supplement - administered alone or with megestrol acetate (MA) - was more effective than MA. Patients and Methods: Four hundred twenty-one assessable patients with cancer-associated wasting were randomly assigned to an EPA supplement 1.09 g administered bid plus placebo; MA liquid suspension 600 mg/d plus an isocaloric, isonitrogenous supplement administered twice a day; or both. Eligible patients reported a 5-lb, 2-month weight loss and/or intake of less than 20 calories/kg/d. Results: A smaller percentage taking the EPA supplement gained ≥ 10% of baseline weight compared with those taking MA: 6% v 18%, respectively (P = .004). Combination therapy resulted in weight gain of ≥ 10% in 11% of patients (P = .17 across all arms). The percentage of patients with appetite improvement (North Central Cancer Treatment Group Questionnaire) was not statistically different: 63%, 69%, and 66%, in EPA-, MA-, and combination-treated arms, respectively (P = .69). In contrast, 4-week Functional Assessment of Anorexia/Cachexia Therapy scores suggested MA-containing arms experienced superior appetite stimulation compared with the EPA arm, with scores of 40, 55, and 55 in EPA-, MA-, and combination-treated arms, respectively (P = .004). Survival was not significantly different among arms. Global quality of life was not significantly different among groups. With the exception of increased impotence in MA-treated patients, toxicity was comparable. Conclusion: This EPA supplement, either alone or in combination with MA, does not improve weight or appetite better than MA alone.
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U2 - 10.1200/JCO.2004.06.024
DO - 10.1200/JCO.2004.06.024
M3 - Article
C2 - 15197210
AN - SCOPUS:2942706075
SN - 0732-183X
VL - 22
SP - 2469
EP - 2476
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 12
ER -