β-Hydroxy-β-methyl Butyrate/L-Arginine/L-Glutamine Supplementation for Preventing Hand–Foot Skin Reaction in Sorafenib for Advanced Hepatocellular Carcinoma

Naganuma, Atsushi; Hoshino, Takashi; Ohno, Nozomi; Ogawa, Yoshihide; Murakami, T.; Horiguchi, Suguru; Uehara, Daisuke; Suzuki, Yuhei; Hatanaka, Takeshi; Kudo, Toshifumi; Ishiguro, Hiroshi; Sato, Ken; Kakizaki, Satoru; Takagi, Hitoshi

doi:10.21873/invivo.11452

Cited by 12 publications

(42 citation statements)

References 20 publications

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“…A beneficial effect of HMB supplementation on reducing serum C‐reactive protein levels was shown in two NRSIs 53,58 ( Figure 2); however, controls receiving glutamine alone presented with greater reductions in this inflammatory marker 53 . Supplementation with HMB/Arg/Gln also had a beneficial effect on tumour response in patients undergoing sorafenib treatment in another NRSI 48 . Compared with historical controls, tumour response rate was similar and a greater disease control rate was found in patients receiving the supplement 48 ( Figure 2).…”

Section: Resultsmentioning

confidence: 90%

“…Nine NRSIs (60.0%) of varied designs met the eligibility criteria, including a total of 527 patients (mean or median range: 62.3–69.0 years) with diverse cancer types and stages. A supplement containing HMB/Arg/Gln was taken by patients in seven studies 48–53,59 . Of these, one trial 59 prescribed HMB/Arg/Gln in combination with HMB‐enriched ONS for patients with mild or severe protein‐energy malnutrition.…”

Section: Resultsmentioning

confidence: 99%

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Effects of β‐hydroxy β‐methylbutyrate (HMB) supplementation on muscle mass, function, and other outcomes in patients with cancer: a systematic review

Prado

Orsso

Pereira

et al. 2022

J cachexia sarcopenia muscle

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Low muscle mass is prevalent among patients with cancer and a predictor of adverse clinical outcomes. To counteract muscle loss, β-hydroxy β-methylbutyrate (HMB) supplementation has been proposed as a potential therapy for older adults and various diseases states. This systematic review aimed to investigate the effects and safety of HMB supplementation in relation to muscle mass and function and other clinical outcomes in patients with cancer. A systematic search of MEDLINE, CINAHL, Embase, Cochrane Central Register of Controlled Trials, Scopus, ProQuest, and grey literature for reports published from inception to December 2021 was conducted. Included studies provided supplements containing any dose of HMB to adult patients with active cancer. A synthesis without meta-analysis was conducted using a vote-counting approach based solely on the direction of the effect (i.e. regardless of statistical significance). Risk of bias was assessed for each outcome domain, and evidence from higher-quality studies (i.e. those with either low or moderate risk of bias) was examined. Safety was evaluated using both lower-quality and higher-quality studies. Fifteen studies were included, in which six were randomized controlled trials in patients with various cancer types and treatments. Studies prescribed HMB combined with amino acids (73.3%), HMB in oral nutritional supplements (20.0%), or both supplement types (6.7%); Ca-HMB doses of 3.0 g/day were provided in 80.0% of the studies. Four studies had high risk of bias across all outcome domains. Considering the higher-quality studies, evidence of a beneficial effect of HMB supplementation was found in four of four studies for muscle mass, two of two for muscle function, three of three for hospitalization, and five of seven for survival. In contrast, no beneficial effects of HMB on quality of life or body weight was found in two of four and three of five studies, respectively. A limited number of higher-quality studies evaluating the impact of HMB on cancer therapy-related toxicity, inflammation, and tumour response were observed. No serious adverse effects directly related to the nutrition intervention were reported. Although limited, current evidence suggests that HMB supplementation has a beneficial effect on muscle mass and function in patients with cancer. Well-designed trials are needed to further explore the clinical benefit of HMB supplementation in this patient population.

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Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

Effects of β‐hydroxy β‐methylbutyrate (HMB) supplementation on muscle mass, function, and other outcomes in patients with cancer: a systematic review

Prado

Orsso

Pereira

et al. 2022

J cachexia sarcopenia muscle

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“…27 In addition, there was another similar trial using combined oral nutritional supplement and sorafenib in patients with HCC, the results suggested that prophylactic HMB, L-arginine and L-glutamine supplementation effectively prevented sorafenib-associated HFSR in patients with advanced HCC. 28 However, these studies only provided some prophylaxis strategies but not the treatment strategy of HFSR. Previous studies showed that modified Taohongsiwu decoction and Compound Danxiong Granules (CDG) could effectively attenuate MKIs-associated HFSR.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of the Shouzu Ning Decoction Treatment for Multi-Kinase Inhibitors-Associated Severe Hand–Foot Skin Reaction

Shou¹,

Shao²,

Zhao³

et al. 2021

CMAR

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Background: Multi-kinase inhibitors (MKIs) treatment plays an important role in cancer therapy, but still suffers from a high incidence of hand-foot skin reaction (HFSR), leading to MKIs dose modification or termination. Thus, there is a high need for therapeutic strategy for HFSR. Patients and Methods: This prospective analysis included twenty patients, who were continuously administered with MKIs treatment and presented with a grade 3 HFSR during January 2018 to December 2019. All the patients were treated with the Shouzu Ning Decoction (SND) twice a day, in addition to the MKIs treatment. Grading of HFSR was assessed by National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Pain intensity was evaluated using the numerical rating scale (NRS). Quality of life was assessed using the Hand-Foot Quality of Life Scale (HF-QoLS). Results: The median time from MKIs initiation to onset of grade 3 HFSR was 26.2 days. Following the SND treatment, seventeen (17/20) patients displayed grade 2 HFSR with a median time of 5.1 days. Among whom, seven (7/17) finally transformed to grade 1 with a median time of 9.9 days. While all of the grade 1 patients (7/7) had local recurrence, and retreatment of the SND was effective. In addition, after the SND treatment, the score of NRS and HF-QoLS decreased to 1.60 ± 1.14 (P < 0.01) and 26.75 ± 11.76 (P < 0.01), respectively. Conclusion:The SND treatment could alleviate symptoms, relieve pain and improve quality of life in HFSR patients. The SND treatment was proved to be an effective and welltolerated treatment for MKIs-associated grade 3 HFSR patients for the first time. Indeed, further randomized controlled trails with large-scale, multi-center are require to fully determine the clinical application of the SND in MKIs-associated HFSR.

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“…Recently, Naganuma et al. ( 64 ) found that prophylactic administration of an ONS (oral nutritional supplement) containing these ingredients before the initiation of sorafenib treatment could effectively decrease the incidence of HFSR. Other possible medications include analgesics (e.g.…”

Section: Histology Of Hfsrmentioning

confidence: 99%

“…It has been proved that b-hydroxy-b-methylbutyrate (HMB), Larginine, and L-glutamine could promote collagen synthesis in the process of wound healing. Recently, Naganuma et al (64) found that prophylactic administration of an ONS (oral nutritional supplement) containing these ingredients before the initiation of sorafenib treatment could effectively decrease the incidence of HFSR. Other possible medications include analgesics (e.g.…”

Section: Other Medicationsmentioning

confidence: 99%

Apatinib-Induced Hand–Foot Skin Reaction in Chinese Patients With Liver Cancer

et al. 2021

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Apatinib, an anti-tumor drug selectively targeting VEGFR2 (Vascular Endothelia Growth Factor Recpetor-2), has been proven effective in Chinese patients with liver cancer. Generally, treatment with apatinib achieves 16.1% of the overall objective remission rate (ORR) and 55.83% of the disease control rate (DCR) in Chinese patients with liver cancer. However, the prevalence of apatinib-induced hand–foot skin reaction (AI-HFSR) is noticeably high. The incidence of AI-HFSR is about 50.5%, of which Grades 1/2 and 3 are 38.8 and 11.6%, respectively. In addition, potential molecular mechanisms underlying the development of AI-HFSR are poorly understood and urgently needed to be investigated histologically. In this review, we summarize and review the current efficacy of apatinib and the prevalence of AI-HFSR in Chinese patients with liver cancer. Besides, we postulate the potential mechanisms underlying the development of AI-HFSR and discuss the optimal clinical management for this unwanted cutaneous side effect.

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β-Hydroxy-β-methyl Butyrate/L-Arginine/L-Glutamine Supplementation for Preventing Hand–Foot Skin Reaction in Sorafenib for Advanced Hepatocellular Carcinoma

Cited by 12 publications

References 20 publications

Effects of β‐hydroxy β‐methylbutyrate (HMB) supplementation on muscle mass, function, and other outcomes in patients with cancer: a systematic review

Effects of β‐hydroxy β‐methylbutyrate (HMB) supplementation on muscle mass, function, and other outcomes in patients with cancer: a systematic review

The Efficacy and Safety of the Shouzu Ning Decoction Treatment for Multi-Kinase Inhibitors-Associated Severe Hand–Foot Skin Reaction

Apatinib-Induced Hand–Foot Skin Reaction in Chinese Patients With Liver Cancer

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