Body Mass In Cancer Patients Research Articles

Effects of omega-3 supplementation on lean body mass in cancer patients: a systematic review and meta-analysis.

Omega-3 fatty acids are bioactive nutrients with the potential to preserve lean body mass in individuals with cancer. This study aimed to review the literature on randomized clinical trials that evaluated the effects of omega-3 supplementation on lean body mass in cancer patients. As secondary objectives, we evaluated the effects of omega-3 supplementation on body mass index (BMI) and body weight. We conducted a systematic review and meta-analysis in the following databases: Pubmed, LILACS, Scielo, Scopus, Web of Science, Cochrane, and Embase. It included randomized clinical trials that investigated the effects of omega-3 supplementation on lean body mass in cancer patients. Observational studies, animal experiments, studies carried out with healthy humans, and non-randomized clinical trials were excluded. We utilized the Cochrane scale to assess the quality of the studies. A meta-analysis was carried out to evaluate the effect of omega-3 on lean body mass, BMI, and body weight. Fourteen studies were included, of which four showed significant results from omega-3 supplementation for lean body mass. In the meta-analysis, omega-3 fatty acids increased lean body mass by 0.17 kg compared to placebo, but without significant differences between the groups [SMD: 0.17; CI 95%: -0.01, 0.35; I2 = 41%]. For body weight, omega-3 showed a statistically significant effect [SMD: 0.26; CI 95%: 0.06, 0.45; I2 = 46%], whereas for BMI the results were not significant. This systematic review and meta-analysis showed no statistically significant effect from omega-3 on lean body mass and BMI. On the other hand, there was a statistical significance for body weight.

Creatinine-to-cystatin C ratio and bioelectrical impedance analysis for the assessement of low lean body mass in cancer patients: Comparison to L3-computed tomography scan.

Lean body mass (LBM) is an important prognostic factor in patients with cancer. Although the L3-computed tomography (CT) scan is considered a reference method for assessment, a convenient and easily available method for longitudinal follow-up is required. Although bioelectrical impedance analysis (BIA) is widely used, its accuracy is questioned; plasma creatinine-to-cystatin C (CC) ratio could be an attractive alternative. The aim of this study was to evaluate the ability of the CC ratio and BIA to detect myopenia in patients with cancer compared with the use of the CT scan as a standard. Patients with any kind of cancer had body composition evaluation by CT scan, BIA, and CC. Statistical analysis included correlation test, Bland-Altman, and receiver operating characteristic curve analysis. Forty-four patients (14 women) were included. Of the participants, 59% had myopenia on CT scan. Both BIA LBM and CC ratio were well correlated with CT scan LBM (r=0.763 and 0.648, respectively) but concordance analysis revealed a 3-kg constant bias toward BIA compared with CT scan. In terms of ability to detect myopenia, areas under the curve (AUC) for BIA were 0.675 and 0.388 for men and women, respectively. For CC ratio, AUCs were 0.813 and 0.673. This study demonstrated that LBM assessed by the CC ratio or BIA is well correlated with that determined by L3-CT scan. The ability of the CC ratio to detect myopenia was better than that of BIA. Findings from the present study demonstrated that CC ratio can be conveniently used in patients with cancer as a reliable biomarker of muscularity.

The Level of Serum Cholesterol is Negatively Associated with Lean Body Mass in Korean non-Diabetic Cancer Patients

Due to poor nutrition and abnormal energy metabolism, cancer patients typically experience the loss of muscle mass. Although the diabetic conditions or dyslipidemia have been reported as a causal link of cancer but the consequence of such conditions in relation to gain or loss of skeletal muscle mass in cancer patients has not been well documented. The purpose of this study was to investigate the relationship of lean body mass and systemic parameters related to lipid metabolism in non-diabetic cancer patients using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008-2011. As results the level of serum total cholesterol (total-C) was negatively associated with both total lean body mass and appendicular lean body mass in cancer patients after adjustment for sex, physical activity, energy intake and comorbidity. The associations between consumption of dietary factors (energy, carbohydrate, protein and fat) and lean body mass were disappeared after adjusting comorbidities of cancer patients. Multivariate-adjusted linear regression analysis by quartiles of serum total-C showed that higher quartile group of total-C had significantly lower percent of lean body mass than reference group in cancer patients. The data indicate that serum lipid status can be the potential estimate of loss of skeletal muscle mass in cancer patients and be referenced in nutrition care of cancer patients under the onset of cachexia or parenteral/enteral nutrition. This data need to be confirmed with large pool of subjects and should be specified by stage of cancer or the site of cancer in future studies.

Effects of the ghrelin receptor agonist anamorelin on lean body mass in cancer patients with cachexia; results from a Phase II randomized, double blind, multicenter study

Background Cancer anorexia-cachexia is a frequent, debilitating and life-threatening condition in which altered metabolism and reduced food intake contribute to weight loss (mainly due to lean body mass [LBM] loss), which cannot be reverted by conventional nutritional support. Safe/effective treatments for cancer cachexia remain an unmet need. The hunger hormone ghrelin has been shown to activate key pathways in the regulation of body composition. Anamorelin (ANAM) is a novel, selective, oral ghrelin receptor agonist with appetiteenhancing and anabolic activity. Anamorelin is currently being investigated in phase III studies for the treatment of anorexia-cachexia in advanced non-small cell lung cancer (also known as the ROMANA program). Material and Methods Eighty-two patients with advanced cancer, ECOG performance score ≤ 2 and weight loss 5% within prior 6 months were treated with placebo (n=36) or 50mg anamorelin (n=38) once daily for 12 weeks. Body composition by DXA, handgrip strength (HGS) and Quality of Life (QoL; ASAS scale) were assessed at baseline, 4, 8 and 12 weeks. Solid tumors represented prevalent malignancy (>93%) with no difference in cancer types between treatment groups. Results Treatment with anamorelin for 12 weeks significantly increased total body mass (TBM) and LBM. Increases in LBM and TBM in anamorelin-treated patients were strongly correlated (r 2 =0.7249, p< 0.0001). Anamorelin treatment improvements in HGS and QoL were previously presented [1]. Anamorelin was well tolerated, and types and prevalence of AEs were similar between treatment arms.

1588P - Anamorelin's Effects on Appendicular Lean Body Mass in Cancer Patients with Cachexia; Results from A Phase II Randomized, Double Blind, Multicenter Study

ABSTRACT Background Cancer cachexia is associated with increased morbidity and poor survival, and is characterized by decreased muscle strength and overall lean body mass including in the extremities (appendicular LBM or aLBM). As most lean tissue in the extremities is striated muscle, aLBM is a good surrogate for muscle mass. Anamorelin is an investigational orally active ghrelin receptor agonist with orexigenic and anabolic activity. We present here a Phase II study post-hoc analysis on a subset of patients who were assessed for aLBM. Methods A Phase II trial enrolled patients with advanced cancer, performance score ≤ 2 and weight loss ≥5% within 6 months from enrollment. Patients were randomized to treatment with placebo (PL) or 50mg anamorelin (ANA) once daily for 12 weeks. Eighty-two patients were assessed for total LBM by DXA, handgrip strength (HGS) and Quality of Life (QoL; ASAS scale) at baseline, 4, 8 and 12 weeks. For 72 subjects (N = 38, ANA; N = 34, PL), data was also available for aLBM. Solid tumors represented prevalent malignancy (>93%) with no difference in cancer types between treatment groups Results Analysis of aLBM indicated that PL-treated patients lost aLBM in the arms during the whole 12 weeks, while aLBM in the legs was more stable. In ANA-treated patients, aLBM increased significantly in the arms and in the legs. At week 12, the percentage change from baseline of aLBM in arms + legs showed a statistically significant increase in ANA vs PL groups (5.8% and 1.5%, respectively; p Conclusion Decreased LBM and HGS are poor prognostic factors in cancer cachexia patients. This study demonstrates that 50mg ANA treatment for 12 weeks significantly increased aLBM and HGS. Together with the orexigenic activity of ANA, these results support the use of ANA in treating cancer cachexia/anorexia and the evaluation of higher ANA doses. Disclosure J.M. Garcia: I receive research support from Helsinn, Y. Yan: I am an Helsinn employee E. Duus: I am an Helsinn employee, J. Friend: I am an Helsinn employee.

Cytokine gene polymorphisms and susceptibility to cachexia

Cachexia is a progressive deterioration of body habitus associated with chronic diseases. The finding that only a proportion of patients with chronic disease develop cachexia has prompted studies looking for genetic polymorphisms that may underlie differential susceptibility. The aim of this review is to explore how inflammation and gene polymorphisms influence susceptibility to cachexia. There has been evidence that certain cytokine gene polymorphisms are associated with cachexia. However, only the IL10 -1082 G allele, which is associated with an increased risk of developing cachexia has been replicated in more than one study. Variation in genes outwith inflammation pathways (e.g. genes involved in protein metabolism) is also likely to contribute the susceptibility of developing cachexia. The insertion/deletion angiotensin converting enzyme (ACE) gene polymorphism has recently been linked with lower lean body mass in cancer patients with cachexia. Although there is an increasing body of evidence of genetic susceptibility to cachexia, most studies so far have only focussed on a small number of polymorphisms and have small sample sizes. Large-scale candidate gene studies or genome-wide association studies are required to further elucidate the link between genotype and cachexia.

Does an increased adreno-cortical activity explain loss of lean body mass in cancer patients : [formula omitted], C. Drott & K. Lundholm.Departments of Surgery II & I, Sahlgrenska Hospital, Gothenburg, Sweden

Does an increased adreno-cortical activity explain loss of lean body mass in cancer patients : [formula omitted], C. Drott & K. Lundholm.Departments of Surgery II & I, Sahlgrenska Hospital, Gothenburg, Sweden