Overview

Multimodal Intervention for Cachexia in Advanced Cancer Patients Undergoing Chemotherapy

Status:
Recruiting
Trial end date:
2022-01-01
Target enrollment:
0
Participant gender:
All
Summary
Cancer cachexia is a multi-factorial syndrome defined by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment. There is an urgency for improving management, but there is no consensus on the optimal treatment for cancer cachexia. Several single therapies for cancer cachexia have been examined in clinical trials, with disappointing overall results. As multiple factors are responsible for the development of cachexia, it has been argued that optimal cachexia interventions should target all components: multimodal therapy for a multimodal problem. The overall aim of this study is to early prevent the development of cachexia rather than treatment late in the disease trajectory. From a patient perspective a short term effect will be to improve physical and psychological function, to reduce symptom burden and to improve survival. In other words live a longer and better life during and after chemotherapy. Direct effects of the cachexia intervention are expected to be reduction of weight and muscle loss, and improved physical activity and quality of life.
Phase:
Phase 3
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Norwegian University of Science and Technology
Collaborators:
Beatson West of Scotland Cancer Centre
Cancer Research UK Edinburgh Centre
Cantonal Hospital of St. Gallen
Cedars-Sinai Medical Center
Chelsea and Westminister Hospital NHS
Cross Cancer Institute
Guy's and St Thomas' NHS Foundation Trust
Jewish General Hospital
Malteser Krankenhaus Seliger Gerhardt
NHS Forth Valley
Oslo University Hospital
Ottawa Regional Cancer Centre
Queen Margaret Hospital, Dunfermline
St. Olavs Hospital
The Beatson West of Scotland Cancer Centre
Tumor Biology Center Freiburg
Tumor Zentrum Aarau
Treatments:
Ibuprofen
Criteria
Inclusion Criteria:

- Diagnosis of lung cancer, pancreatic cancer or cholangiocarcinoma where the diagnosis
is based on histological, radiological or multidisciplinary team (MDT) evaluation

- non-small cell lung cancer (stage III or IV), pancreatic adenocarcinoma (stage III or
IV), due to commence first or second line anticancer treatment (defined as
chemotherapy, chemo-radiotherapy, targeted therapy or immunotherapy)

- staging CT within 4 weeks of commencement of anti-cancer therapy (in patients where
staging CT is out-with this period, further CT scanning will be undertaken. PETCT's
are also appropriate)

- completed all other baseline assessments within one week prior to first course of
anti-cancer treatment

- written informed consent

- able to comply with trial interventions (in the opinion of referring clinician) e.g.
willing and able to do light exercise and take oral nutritional supplements as well as
no major contraindications against ibuprofen.

- Karnofsky Performance Status >70

Exclusion Criteria:

- Neuro-endocrine pancreatic cancer

- Creatinine clearance <30ml/min

- Receiving parenteral nutrition or enteral nutrition via feeding tube

- receiving neo-adjuvant anti-cancer therapy

- BMI >30 kg/m2

- Use of appetite stimulants or anabolic/anti-catabolic agents (such as megestrol
acetate, progestational agents, marijuana growth hormone, dronabinol, or other
anabolic agent) within 30 days prior to study baseline

- Concomitant steroid (>10mg/d prednisolone or equivalent) treatment for less than three
months prior to inclusion (inhaled, optical or pulsed oral steroids (up to 10 days
use) are permitted)

- Concomitant long term (>1 week) nonsteroidal anti-inflammatory drugs (NSAID) or
aspirin treatment

- pregnancy, breast-feeding or of child bearing potential (that is not postmenopausal or
permanently sterilised) age and not using adequate contraception (oral, injected,
implanted or hormonal methods of contraception, intrauterine device and barrier
method)

- Concomitant anti-coagulant treatment (e.g. warfarin or heparin)