title: A randomised feasibility study of EPA and Cox-2 inhibitor (Celebrex) versus EPA, Cox-2 inhibitor (Celebrex), resistance training followed by ingestion of essential amino acids high in leucine in NSCLC cachectic patients--ACCeRT study.
abstract: BACKGROUND
  Cancer cachexia is a syndrome of progressive weight loss. Non-small cell lung cancer patients experience a high incidence of cachexia of 61%. Research into methods to combat cancer cachexia in various tumour sites has recently progressed to the combination of agents.The combination of the anti-cachectic agent Eicosapentaenoic acid (EPA) and the cyclo-oxygenase-2 (COX-2) inhibitor celecoxib has been tested in a small study with some benefit. The use of progressive resistance training (PRT) followed by the oral ingestion of essential amino acids (EAA), have shown to be anabolic on skeletal muscle and acceptable in older adults and other cancer groups.The aim of this feasibility study is to evaluate whether a multi-targeted approach encompassing a resistance training and nutritional supplementation element is acceptable for lung cancer patients experiencing cancer cachexia.
  
  
  METHODS
  Auckland's Cancer Cachexia evaluating Resistance Training (ACCeRT) is an open label, prospective, randomised controlled feasibility study with two parallel arms. All patients will be treated with EPA and the COX-2 inhibitor celecoxib on an outpatient basis at the study site. In the experimental group patients will participate in PRT twice a week, followed by the ingestion of essential amino acids high in leucine. A total of 21 patients are planned to be enrolled. Patients will be randomised using 1:2 ratio with 7 patients enrolled into the control arm, and 14 patients into the treatment arm. The primary endpoint is the acceptability of the above multi-targeted approach, determined by an acceptability questionnaire.
  
  
  CONCLUSIONS
  To our knowledge ACCeRT offers for the first time the opportunity to investigate the effect of stimulating the anabolic skeletal muscle pathway with the use of PRT along with EAA alongside the combination of EPA and celecoxib in this population.
  
  
  BACKGROUND
  Netherlands Trial Register (NTR): ACTRN12611000870954.
authors: Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand. elaine.rogers@adhb.govt.nz
authors: Elaine S
authors: ES
authors: Rogers
authors: Roderick D
authors: RD
authors: MacLeod
authors: Joanna
authors: J
authors: Stewart
authors: Stephen P
authors: SP
authors: Bird
authors: Justin W L
authors: JW
authors: Keogh
mesh_terms: D000328:Adult; D000601:Amino Acids, Essential / Q000627:therapeutic use; D002100:Cachexia / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000628:therapy; D000068579:Celecoxib; D003131:Combined Modality Therapy / Q000379:methods; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D019587:Dietary Supplements; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007930:Leucine / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D017060:Patient Satisfaction; D011446:Prospective Studies; D011720:Pyrazoles / Q000627:therapeutic use*; D055070:Resistance Training; D013449:Sulfonamides / Q000627:therapeutic use*
chemical_list: D000601:Amino Acids, Essential; D052246:Cyclooxygenase 2 Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D015118:Eicosapentaenoic Acid; D007930:Leucine; D000068579:Celecoxib