Nutrition intervention using an eicosapentaenoic acid (EPA)-containing supplement in patients with advanced colorectal cancer. Effects on nutritional and inflammatory status: a phase II trial.

Abstract

GOALS:

The aim of the study was to assess the impact of an eicosapentanoic acid-containing protein and energy dense oral nutritional supplement (EPA-ONS) on nutritional and inflammatory status, quality of life (QOL), plasma phospholipids (PPL) and cytokine profile, tolerance of irinotecan-containing chemotherapy and EPA-ONS in patients with advanced colorectal cancer (CRC) receiving chemotherapy.

MATERIALS AND METHODS:

Patients with advanced CRC having one prior chemotherapy regimen received 480 ml of EPA-ONS daily for 3 weeks before commencing chemotherapy with folinic acid, 5-fluorouracil, irinotecan (FOLFIRI), and continued for 3 cycles of treatment (9 weeks). All assessments including weight, body composition, C-reactive protein (CRP), QOL, dietary intake, PPL and cytokine analyses were performed at baseline, 3 and 9 weeks.

RESULTS:

Twenty-three patients were enrolled, 20 completed 3 weeks, and 15 completed 9 weeks. The mean EPA-ONS intake was 1.7 tetrapaks (408 ml) daily. There was a significant increase in mean weight (2.5 kg) at 3 weeks (p=0.03). Lean body mass (LBM) was maintained. Protein and energy intake significantly decreased after the commencement of chemotherapy (protein p=0.003, energy p=0.02). There was a significant increase in energy levels (p=0.03), whilst all other QOL measures were maintained. PPL EPA levels increased significantly over the first 3 weeks. Mean CRP increased by 14.9 mg/L over the first 3 weeks (p=0.004), but decreased to baseline levels by the end of the trial. There was a significant correlation between plasma IL-6 and IL-10 concentrations and survival, and between IL-12 and toxicity.

CONCLUSION:

Dietary counseling and the provision of EPA-ONS may result in maintenance of nutritional status and QOL, however randomized trials are required to evaluate the impact of EPA on toxicity from chemotherapy.

• Authors: Jane A Read, Philip J Beale, Dianne H Volker, Narelle Smith, Annabel Childs, Stephen J Clarke
• Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 15 Issue 3 Pg. 301-7 (Mar 2007) ISSN: 0941-4355 [Print] Germany
• PMID: 17021855 (Publication Type: Clinical Trial, Phase II, Journal Article)

Chemical References

• Biomarkers
• Cytokines
• Dietary Proteins
• Phospholipids
• Vitamin B Complex
• Irinotecan
• Eicosapentaenoic Acid
• Leucovorin
• Fluorouracil
• Camptothecin

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Australia
• Biomarkers (blood)
• Body Composition (drug effects)
• Camptothecin (adverse effects, analogs & derivatives)
• Colorectal Neoplasms (complications, drug therapy, metabolism)
• Cytokines (blood, drug effects)
• Dietary Proteins (metabolism, therapeutic use)
• Dietary Supplements
• Eicosapentaenoic Acid (metabolism, therapeutic use)
• Energy Intake (drug effects)
• Female
• Fluorouracil (adverse effects)
• Humans
• Inflammation (metabolism)
• Irinotecan
• Leucovorin (adverse effects)
• Male
• Malnutrition (diet therapy, etiology)
• Middle Aged
• Nutritional Status
• Nutritional Support
• Phospholipids (blood)
• Quality of Life
• Treatment Outcome
• Vitamin B Complex (therapeutic use)