Abstract

Advanced gastrointestinal cancer patients with weight loss and an acute-phase response (n = 15) were given megestrol acetate (480 mg day(-1)) and ibuprofen (1200 mg day(-1)) for 6 weeks. Overall, there was an increase in body weight (P = 0.01) and a reduction in C-reactive protein concentrations (P = 0.02), with no change in total body water (P = 0.24) over this period. This regimen may be an effective non-toxic treatment for cancer cachexia and is worthy of further study.

Highlights

  • In similar studies looking at advanced gastrointestinal cancer patients alone, no significant gain in weight has been documented (Schmoll et al, 1991; McMillan et al, 1994)

  • It is of interest that the majority of patients with advanced gastrointestinal cancer and weight loss have an ongoing acute-phase protein response (McMillan et al, 1994), and we have recently demonstrated that the non-steroidal anti-inflammatory drug, ibuprofen, can reduce mediators of the inflammatory response, such as interleukin-6 and cortisol (McMillan et al, 1995), and metabolic end points, such as the acute-phase protein response (Preston et al, 1995) and resting energy expenditure (Wigmore et al, 1995)

  • There was a significant increase in weight after 6 weeks of megestrol acetate and ibuprofen (P = 0.01), the median weight change of the group being 1.3 kg

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Summary

Objectives

The aim of the present study was to test, in a small group of patients with advanced gastrointestinal cancer, the hypothesis that down-regulating the acute-phase response using ibuprofen and

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