A multi-targeted treatment approch to cancer cachexia: Auckland's Cancer Cachexia evaluating Resistance Training (ACCeRT) trial

Rogers, Elaine S. and Sasidharan, Rita and Sequeira, Graeme M. and Wood, Matthew R. and Bird, Stephen P. ORCID: https://orcid.org/0000-0002-5607-3829 and Keogh, Justin W.L. and Arroll, Bruce and Stewart, Joanna and MacLeod, Roderick D. (2020) A multi-targeted treatment approch to cancer cachexia: Auckland's Cancer Cachexia evaluating Resistance Training (ACCeRT) trial. JCSM Rapid Communications, 3 (1). pp. 11-24.

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Abstract

Abstract Background Cancer cachexia is a condition often seen at diagnosis, throughout anti-cancer treatments and in end-stage nonsmall- cell lung cancer patients. Methods and results Participants with late-stage non-small-cell lung cancer and cachexia (defined as ≥5% weight loss within 12 months) were randomly assigned 1:2 to 2.09 g of eicosapentaenoic acid (EPA) and 300 mg of cyclo-oxygenase-2 inhibitor celecoxib orally once daily vs. same dosing of EPA, celecoxib, plus two sessions per week of progressive resistance training and 20 g of oral essential amino acids high in leucine in a split dose over 3 days, after each session. Primary endpoint was the acceptability of the earlier multi-targeted approach. Main secondary endpoints included change in body weight and fat-free mass, by bioelectric impedance analysis and total quadriceps muscle volume by magnetic resonance imaging over 20 weeks. Sixty-nine patients were screened resulting in 20 patients being enrolled. Acceptability scored high, with 4.5/5 (Arm A) and 5/5 (Arm B) for EPA and 5/5 for celecoxib within both arms and 4.8/5 for progressive resistance training sessions and 4.5/5 for essential amino acids within Arm B, all at Week 20. Results showed a net gain in bioelectric impedance analysis fat-free mass of +1.3 kg, n = 2 (Arm A), compared with +0.7 kg, n = 7 (Arm B) at Week 12, and —1.5 kg, n = 2 (Arm A), compared with —1.7 kg, n = 4 (Arm B) at Week 20. Trends in efficacy in terms of improvement and/or stability in cachexia markers were seen within magnetic resonance imaging muscle volume, albumin, and C-reactive protein levels within both arms. There were no exercise-related adverse events, with one possible related adverse event of asymptomatic atrial fibrillation in one participant within Arm A. Conclusions Non-small-cell lung cancer cachectic patients are willing to be enrolled onto a multi-targeted treatment regimen and may benefit from cachexia symptom management even during the late/refractory stage.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Health and Wellbeing (1 Jan 2015 -)
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Health and Wellbeing (1 Jan 2015 -)
Date Deposited: 01 Sep 2020 06:01
Last Modified: 14 Sep 2020 01:06
Uncontrolled Keywords: Cancer, Cachexia, Resistance training, Amino acids
Fields of Research (2008): 11 Medical and Health Sciences > 1112 Oncology and Carcinogenesis > 111204 Cancer Therapy (excl. Chemotherapy and Radiation Therapy)
11 Medical and Health Sciences > 1111 Nutrition and Dietetics > 111101 Clinical and Sports Nutrition
Socio-Economic Objectives (2008): C Society > 92 Health > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920102 Cancer and Related Disorders
Identification Number or DOI: 10.1002/rco2.10
URI: http://eprints.usq.edu.au/id/eprint/39124

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