An eicosapentaenoic acid supplement versus megestrol acetate versus both for patients with cancer-associated wasting: a North Central Cancer Treatment Group and National Cancer Institute of Canada collaborative effort.
OBJECTIVE
Studies suggest eicosapentaenoic acid (EPA), an omega-3 fatty acid, augments weight, appetite, and survival in cancer-associated wasting. This study determined whether an EPA supplement-administered alone or with megestrol acetate (MA)-was more effective than MA.


METHODS
Four hundred twenty-one assessable patients with cancer-associated wasting were randomly assigned to an EPA supplement 1.09 g administered bid plus placebo; MA liquid suspension 600 mg/d plus an isocaloric, isonitrogenous supplement administered twice a day; or both. Eligible patients reported a 5-lb, 2-month weight loss and/or intake of less than 20 calories/kg/d.


RESULTS
A smaller percentage taking the EPA supplement gained >or= 10% of baseline weight compared with those taking MA: 6% v 18%, respectively (P =.004). Combination therapy resulted in weight gain of >or= 10% in 11% of patients (P =.17 across all arms). The percentage of patients with appetite improvement (North Central Cancer Treatment Group Questionnaire) was not statistically different: 63%, 69%, and 66%, in EPA-, MA-, and combination-treated arms, respectively (P =.69). In contrast, 4-week Functional Assessment of Anorexia/Cachexia Therapy scores suggested MA-containing arms experienced superior appetite stimulation compared with the EPA arm, with scores of 40, 55, and 55 in EPA-, MA-, and combination-treated arms, respectively (P =.004). Survival was not significantly different among arms. Global quality of life was not significantly different among groups. With the exception of increased impotence in MA-treated patients, toxicity was comparable.


CONCLUSIONS
This EPA supplement, either alone or in combination with MA, does not improve weight or appetite better than MA alone.
Jatoi
Aminah
A
Mayo Clinic and Foundation, Rochester, MN 55905, USA. jatoi.aminah@mayo.edu
Rowland
Kendrith
K
Loprinzi
Charles L
CL
Sloan
Jeff A
JA
Dakhil
Shaker R
SR
MacDonald
Neil
N
Gagnon
Bruno
B
Novotny
Paul J
PJ
Mailliard
James A
JA
Bushey
Teresita I L
TI
Nair
Suresh
S
Christensen
Brad
B
D000368:Aged; D001066:Appetite / Q000187:drug effects; D019167:Appetite Stimulants / Q000008:administration & dosage; D001835:Body Weight; D002170:Canada; D019587:Dietary Supplements; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D019290:Megestrol Acetate / Q000008:administration & dosage*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D011788:Quality of Life; D015996:Survival Rate; D019282:Wasting Syndrome / Q000188:drug therapy*
D019167:Appetite Stimulants; D015118:Eicosapentaenoic Acid; D019290:Megestrol Acetate