title: Guarana (Paullinia cupana) Improves Anorexia in Patients with Advanced Cancer.
abstract: OBJECTIVE
  Anorexia is prevalent in cancer patients with advanced disease. In this pilot phase II, open label, nonrandomized trial, we evaluated the efficacy and safety of guarana (Paullinia cupana) in patients with cancer and weight loss.
  
  
  METHODS
  We included advanced cancer patients with decreased appetite and weight loss of more than 5% from their baseline. All of the patients received 50 mg of the crude dry extract of guarana twice a day for 4 weeks. The trial was designed in two phases (Simon model). We considered a positive response in the first phase to be at least 5% weight gain or a three-point improvement in the appetite scale in at least three of the first 18 evaluable patients.
  
  
  RESULTS
  Of the 34 eligible patients, 30 were included and 18 completed the protocol. Only one patient abandoned the protocol due to toxicity (grade II arthralgia). No grade 3 or 4 toxicities and no significant differences in nausea, weight loss, or quality of life (FACT-G) occurred. Only two of the 18 patients who completed the study had weight gain above 5% from their baseline, whereas six patients had at least a 3-point improvement in the visual appetite scale. The M.D. Anderson Symptom Inventory (MDASI) was used to evaluate several symptoms, and we observed a significant decrease in the lack of appetite (p = 0.02) and in somnolence (p = 0.0142).
  
  
  CONCLUSIONS
  We concluded that the weight stabilization and increased appetite that we observed in this study justify further studies of guarana in this patient population.
authors.affiliation: a 1 Department of Hematology and Oncology, ABC Foundation Medical School, Santo André, São Paulo, Brazil.
authors.forename: Cláudia G Latorre
authors.initials: CG
authors.lastname: Palma
authors.affiliation: b 2 Clinical Medicine, Department of General Medicine, ABC Foundation Medical School, Santo André, São Paulo, Brazil.
authors.forename: Andrea Thaumaturgo
authors.initials: AT
authors.lastname: Lera
authors.affiliation: c 3 ABC Foundation Medical School, Santo André, São Paulo, Brazil.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Lerner
authors.affiliation: c 3 ABC Foundation Medical School, Santo André, São Paulo, Brazil.
authors.forename: Manuella Missawa
authors.initials: MM
authors.lastname: de Oliveira
authors.affiliation: c 3 ABC Foundation Medical School, Santo André, São Paulo, Brazil.
authors.forename: Thaís Mazará
authors.initials: TM
authors.lastname: de Borta
authors.affiliation: c 3 ABC Foundation Medical School, Santo André, São Paulo, Brazil.
authors.forename: Renata Possebon
authors.initials: RP
authors.lastname: Barbosa
authors.affiliation: c 3 ABC Foundation Medical School, Santo André, São Paulo, Brazil.
authors.forename: Gisele Mendes
authors.initials: GM
authors.lastname: Brito
authors.affiliation: c 3 ABC Foundation Medical School, Santo André, São Paulo, Brazil.
authors.forename: Camila Ada
authors.initials: CA
authors.lastname: Guazzelli
authors.affiliation: a 1 Department of Hematology and Oncology, ABC Foundation Medical School, Santo André, São Paulo, Brazil.
authors.forename: Felipe José Melo
authors.initials: FJ
authors.lastname: Cruz
authors.affiliation: d 4 Department of Hematology and Oncology, ABC Foundation Medical School, Santo André, São Paulo, Brazil.
authors.forename: Auro
authors.initials: A
authors.lastname: del Giglio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000188:drug therapy*; D001066:Appetite / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D032126:Paullinia / Q000737:chemistry*; D008517:Phytotherapy; D010865:Pilot Projects; D010936:Plant Extracts / Q000494:pharmacology*; D011788:Quality of Life; D015430:Weight Gain / Q000187:drug effects
chemical_list: D010936:Plant Extracts
keywords: anorexia; appetite loss; cachexia; guarana; palliative cancer treatment