Comparison of Three Different Treatment Modalities in the Management of Cancer Cachexia

Kanat, Özkan; Çubukçu, Erdem; Avcı, Nilüfer; Budak, Ferah; Ercan, İlker; Canhoroz, Mustafa; Olmez, Fatih

doi:10.1177/030089161309900218

Cited by 28 publications

(27 citation statements)

References 27 publications

(31 reference statements)

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“…We found two studies for the quality of life gain analysis, both in cancer participants. , The results did not show differences (standardized mean difference −3.89, 95% CI [−14.07, 6.28]; 2 studies, 99 participants).…”

Section: Resultsmentioning

confidence: 88%

See 1 more Smart Citation

Megestrol acetate for cachexia–anorexia syndrome. A systematic review

Ruı́z-Garcı́a

López-Briz

Carbonell-Sanchis

et al. 2018

J cachexia sarcopenia muscle

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In 1993, megestrol acetate (MA) was approved by the US Food and Drug Administration for the treatment of anorexia, cachexia, or unexplained weight loss in patients with acquired immunodeficiency syndrome. The mechanism by which MA increases appetite is unknown, and its effectiveness for anorexia and cachexia in neoplastic, elderly, and acquired immunodeficiency syndrome patients is under investigation. This is an updated version of a Cochrane systematic review first published in 2005 and later updated in 2013 entitled ‘Megestrol acetate for the treatment of anorexia–cachexia syndrome’. MA vs. placebo: in studies where MA was compared with placebo, the overall results showed that MA patients gained weight (mean difference, MD 2.25 kg, 95% CI [1.19, 3.3]) but did not gain quality of life (QOL) (standarized mean difference, SMD 0.5, 95% CI [−0.13, 1.13]), with more adverse events (relative risk, RR 1.46, 95% CI [1.05, 2.04]), but no difference in deaths (RR 1.26, 95% CI [0.70, 2.27]). MA vs. no treatment: MA patients gained weight (MD 1.45 kg, 95% CI [0.15, 2.75]) but did not gain QOL (standardized mean difference 3.89 95% CI [−14, 6.28]). There was no increase in adverse events (RR 0.90, 95% CI [0.39, 2.08]) or deaths (RR 1.01, 95% CI [0.42, 2.45]). MA vs. active drugs: MA patients gained weight (MD 2.5 kg, 95% CI [0.37, 4.64]) but did not gain QOL (MD 0.20 95% CI [−0.02, 0.43]) and did not report an increase in adverse events (RR 1.05 95% CI [0.95, 1.16]) or in deaths (RR 1.53, 95% CI [1.02, 2.29]) Different doses of MA: in studies where lower doses of MA were compared with higher doses of MA, we did not find differences either in weight gain (MD −0.94 kg, 95% CI [−3.33, 1.45]), QOL (MD 0.31 95% CI [−0.19, 0.81]), or adverse events (RR 1.34, 95% CI [0.65, 2.76]). Thus, we cannot reach a conclusion for an optimal dose of MA.

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Section: Resultsmentioning

confidence: 88%

“…We found two trials with 101 cancer participants. 28,46 The results showed no differences in adverse events (RR 0.90, 95% CI [0.39, 2.08]). We judged the quality of evidence for adverse events to be very low.…”

Section: Adverse Eventsmentioning

confidence: 95%

Megestrol acetate for cachexia–anorexia syndrome. A systematic review

Ruı́z-Garcı́a

López-Briz

Carbonell-Sanchis

et al. 2018

J cachexia sarcopenia muscle

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“…Three arms randomized clinical trial shows that EPA and megesterol acetate significantly increase body weight, lean body mass, body mass index, quality of life, and decrease serum level of inflammatory cytokines in cachectic cancer patients more than each group alone [230]. The promising effect of omega-3 FA consumption in management of head and neck cancer induced weight loss is also reported [224,231].…”

Section: Cancer Cachexiamentioning

confidence: 93%

Omega-3 polyunsaturated fatty acids and cancer: lessons learned from clinical trials

Nabavi

Bilotto

Russo

et al. 2015

Cancer Metastasis Rev

131

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Over the past decades, extensive studies have addressed the therapeutic effects of omega-3 polyunsaturated fatty acids (omega-3 FAs) against different human diseases such as cardiovascular and neurodegenerative diseases, cancer, etc. A growing body of scientific research shows the pharmacokinetic information and safety of these natural occurring substances. Moreover, during recent years, a plethora of studies has demonstrated that omega-3 FAs possess therapeutic role against certain types of cancer. It is also known that omega-3 FAs can improve efficacy and tolerability of chemotherapy. Previous reports showed that suppression of nuclear factor-κB, activation of AMPK/SIRT1, modulation of cyclooxygenase (COX) activity, and up-regulation of novel anti-inflammatory lipid mediators such as protectins, maresins, and resolvins, are the main mechanisms of antineoplastic effect of omega-3 FAs. In this review, we have collected the available clinical data on the therapeutic role of omega-3 FAs against breast cancer, colorectal cancer, leukemia, gastric cancer, pancreatic cancer, esophageal cancer, prostate cancer, lung cancer, head and neck cancer, as well as cancer cachexia. We also discussed the chemistry, dietary source, and bioavailability of omega-3 FAs, and the potential molecular mechanisms of anticancer and adverse effects.

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“…More than 15 clinical trials have demonstrated that at 160-1600 mg/day, this drug significantly improves appetite and the lean body mass. This drug is being used either alone or as a supplement along with meloxicam for cachectic cancer patients where it has shown positive effects in regulating the loss of body mass [23,152,153]. MA is used to improve appetite and weight gain in AIDS/cancer induced anorexia-cachexia syndrome [154][155][156].…”

Section: Anti-myostatin/activinmentioning

confidence: 99%

Skeletal muscle atrophy: Potential therapeutic agents and their mechanisms of action

Dutt

Gupta

Dabur

et al. 2015

Pharmacological Research

140

110

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Comparison of Three Different Treatment Modalities in the Management of Cancer Cachexia

Abstract: MA plus meloxicam or EPA supplement plus meloxicam may be effective treatment options in the management of cancer cachexia. The combined use of these agents does not provide further advantages.

Cited by 28 publications

References 27 publications

Megestrol acetate for cachexia–anorexia syndrome. A systematic review

Megestrol acetate for cachexia–anorexia syndrome. A systematic review

Omega-3 polyunsaturated fatty acids and cancer: lessons learned from clinical trials

Skeletal muscle atrophy: Potential therapeutic agents and their mechanisms of action

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