Beta-hydroxy beta-methylbutyrate/arginine/glutamine (HMB/Arg/Gln) supplementation to improve the management of cachexia in patients with advanced lung cancer: an open-label, multicentre, randomised, controlled phase II trial (NOURISH)

BMC Cancer

Joyce Thompson¹  Aimee Jackson²  Lucinda Billingham²  Claire Gaunt²  Charlotte Gaskell²  Neil Steven³  Jennifer Pascoe⁴ 

[1] Birmingham Heartlands Hospital, Bordesley Green E, B9 5SS, Birmingham, UK;Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK;Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK;Queen Elizabeth Hospital Birmingham, Mindelsohn Way, B15 2TH, Birmingham, UK;

关键词: Cachexia;    Advanced lung cancer;    Nutritional supplement;    Supportive care;    Clinical trial;   

DOI  :  10.1186/s12885-021-08519-8

来源: Springer

【 摘 要 】

BackgroundCancer cachexia causes significant morbidity and mortality in advanced lung cancer patients. Clinical benefit of β-hydroxy-β-methylbutyrate, arginine, and glutamine (HMB/Arg/Gln) was assessed in newly diagnosed patients.MethodsNOURISH, a prospective, two-arm, open-label, multi-centre, randomised controlled phase II trial compared cachexia in patients who received HMB/Arg/Gln with those who did not. All patients received structured nutritional, exercise and symptom control via a Macmillan Durham Cachexia Pack. Conducted in five UK centres, patients aged > 18 years, with newly diagnosed advanced small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC), who were able to take oral nutrition, with a performance status of 0-to-2 and a life expectancy > 4 months were eligible for trial entry. Patients suitable for treatment with curative intent were ineligible. The trial was designed as a signal-seeking pilot study with target recruitment of 96 patients. One-to-one randomisation was stratified by diagnosis (SCLC or NSCLC), stage of disease (locally advanced or metastatic) and performance status. The primary outcome measure was treatment success defined as a patient being alive without significant loss of lean body mass (not > 5%) by 12 weeks. Secondary outcome measures included quality of life.ResultsBetween February-2012 and February-2013, 38 patients were recruited, 19 to each arm. Baseline characteristics were balanced. The trial was halted due to slow accrual and partial adherence. Trial data demonstrated no evidence of treatment benefit. No serious adverse events were reported during the trial.ConclusionsFurther evaluation of HMB/Arg/Gln in this setting could not be recommended on the basis of this trial.Clinical trial registrationISRCTN registry: 39911673; 14-Apr-2011 https://doi.org/10.1186/ISRCTN39911673.

【 授权许可】

CC BY