Abstract
Background: The optimal treatment of cancer-related malnutrition remains unknown. A single-center prospective cohort study was performed to compare the efficacy of megestrol acetate (MA) combined with oral nutrition supplement (ONS) and MA alone for the treatment of lung cancer-related malnutrition.Methods: 76 eligible patients were prospectively enrolled in two arms, Arm 1 patients (n = 40, 52.6%) received MA 160 mg/d, and Arm 2 patients (n = 36, 47.4%) received MA 160 mg/d combined with ONS 55.8 g/t.i.d, all orally. All patients received anticancer therapy. Treatment duration was 3 months. The primary endpoints were improvements in body mass index (BMI) and Eastern Cooperative Oncology Group (ECOG) score. Secondary endpoints were assessed by appetite, mid-upper arm circumference (MAC), serum pre-albumin levels, and serum albumin levels.Results: Baseline levels were comparable between Arm 1 and Arm 2 patients. Compared with Arm 1, primary endpoints (BMI, P = 0.018; ECOG, P = 0.022) and secondary endpoints (MAC, P = 0.025; serum pre-albumin, P = 0.043; and serum albumin, P = 0.034) were improved significantly after treatment in Arm 2. While toxicity was negligible and comparable between Arm 1 and Arm 2.Conclusion: MA combined with ONS may be an effective and safe treatment option for lung cancer-related malnutrition patients.Clinical Trial Registration:www.clinicaltrials.gov, identifier ChiCTR2100049007.
Highlights
Lung cancer is the second most frequently diagnosed cancer and the most common cause of cancer-related deaths worldwide [1]
megestrol acetate (MA) combined with oral nutrition supplement (ONS) may be an effective and safe treatment option for lung cancer-related malnutrition patients
ONS consists of proteins, carbohydrates, fat, vitamins, and minerals, which could be used as the only source of enteral nutrition (EN) or as nutritional supplements [12,13,14]. The objective of this single-center prospective cohort study was to investigate the efficacy and safety of MA combined with ONS in the treatment of lung cancer-related malnutrition patients. This single-center prospective cohort study compared the efficacy and safety of MA combined with ONS vs. MA in the Abbreviations: ONS, Oral Nutrition Supplement; MA, Megestrol Acetate; body mass index (BMI), Body Mass Index; ECOG, Eastern Cooperative Oncology Group; mid-upper arm circumference (MAC), Midupper Arm Circumference; non-steroidal anti-inflammatory drugs (NSAIDs), Non-Steroidal Anti-Inflammatory Drugs; ASPEN, American Society for Parenteral and Enteral Nutrition; parenteral nutrition (PN), Parenteral Nutrition; nutrition risk score (NRS), Nutrition Risk Score; patient-generated subjective global assessment (PG-SGA), Patient-Generated Subjective Global Assessment; NYHA, New York Heart Association; Nutrition risk score 2002 (NRS2002), Nutrition Risk Score 2002
Summary
Lung cancer is the second most frequently diagnosed cancer and the most common cause of cancer-related deaths worldwide [1]. There is a high prevalence of lung cancer-related malnutrition with reported rates ranging from 34.5 to 69%. Our understanding of malnutrition/cachexia has been greatly improved over the past decades; there was no guidelines or standards of care for the treatment of cancer malnutrition/cachexia were universally established until now [4,5,6]. Appetite stimulants such as megestrol acetate (MA), glucocorticoids, non-steroidal anti-inflammatory drugs (NSAIDs), and dronabinol have been extensively studied in patients with cancer-related malnutrition and were reported to stimulate appetite [7]. A single-center prospective cohort study was performed to compare the efficacy of megestrol acetate (MA) combined with oral nutrition supplement (ONS) and MA alone for the treatment of lung cancer-related malnutrition
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