title: Does megestrol acetate down-regulate interleukin-6 in patients with cancer-associated anorexia and weight loss? A North Central Cancer Treatment Group investigation.
abstract: Megestrol acetate improves appetite and abrogates weight loss in some patients with advanced cancer. Moreover, preliminary studies suggest that progestational agents down-regulate interleukin-6 (IL-6), an inflammatory cytokine widely implicated in cancer-associated anorexia and weight loss. The present investigation examined the effects of megestrol acetate on IL-6 in an attempt to confirm these earlier, preliminary studies. The translational component of a large multi-institutional trial, this investigation examined 85 patients with advanced cancer and weight loss. Patients had been randomly assigned to receive megestrol acetate liquid suspension 800 mg/day + placebo tablets, or oral dronabinol tablets 2.5 mg b.i.d. + liquid placebo, or both agents. Other testing included serial physician-reported weight and patient-reported appetite and global quality of life. We found no significant differences in 1-month changes in serum IL-6 according to whether patients had been treated with megestrol acetate, dronabinol, or the combination: the mean differences +/- standard deviation were -1.52+/-4.7 pg/ml, -0.62+/-3.5 pg/ml, and -0.2+/-3.1 pg/ml, respectively (P=0.40, by one-way ANOVA). Among the patients who noted alterations in their appetite over 1 month, we observed no significant changes in IL-6. Finally, changes in serum IL-6 were not associated with shifts in weight or global quality of life. Our investigation provides no evidence that megestrol acetate down-regulates IL-6 in patients with cancer-associated anorexia and weight loss.
authors.affiliation: Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA. Jatoi.aminah@mayo.edu
authors.forename: Aminah
authors.initials: A
authors.lastname: Jatoi
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Yamashita
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Novotny
authors.forename: Harold E
authors.initials: HE
authors.lastname: Windschitl
authors.forename: Charles L
authors.initials: CL
authors.lastname: Loprinzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D015536:Down-Regulation / Q000187:drug effects*; D013759:Dronabinol / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D019290:Megestrol Acetate / Q000627:therapeutic use*; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D011788:Quality of Life; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D018931:Antineoplastic Agents, Hormonal; D015850:Interleukin-6; D013759:Dronabinol; D019290:Megestrol Acetate