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Nutrition intervention using an eicosapentaenoic acid (EPA)-containing supplement in patients with advanced colorectal cancer. Effects on nutritional and inflammatory status: a phase II trial

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Abstract

Goals

The aim of the study was to assess the impact of an eicosapentanoic acid-containing protein and energy dense oral nutritional supplement (EPA-ONS) on nutritional and inflammatory status, quality of life (QOL), plasma phospholipids (PPL) and cytokine profile, tolerance of irinotecan-containing chemotherapy and EPA-ONS in patients with advanced colorectal cancer (CRC) receiving chemotherapy.

Materials and methods

Patients with advanced CRC having one prior chemotherapy regimen received 480 ml of EPA-ONS daily for 3 weeks before commencing chemotherapy with folinic acid, 5-fluorouracil, irinotecan (FOLFIRI), and continued for 3 cycles of treatment (9 weeks). All assessments including weight, body composition, C-reactive protein (CRP), QOL, dietary intake, PPL and cytokine analyses were performed at baseline, 3 and 9 weeks.

Results

Twenty-three patients were enrolled, 20 completed 3 weeks, and 15 completed 9 weeks. The mean EPA-ONS intake was 1.7 tetrapaks (408 ml) daily. There was a significant increase in mean weight (2.5 kg) at 3 weeks (p = 0.03). Lean body mass (LBM) was maintained. Protein and energy intake significantly decreased after the commencement of chemotherapy (protein p = 0.003, energy p = 0.02). There was a significant increase in energy levels (p = 0.03), whilst all other QOL measures were maintained. PPL EPA levels increased significantly over the first 3 weeks. Mean CRP increased by 14.9 mg/L over the first 3 weeks (p = 0.004), but decreased to baseline levels by the end of the trial. There was a significant correlation between plasma IL-6 and IL-10 concentrations and survival, and between IL-12 and toxicity.

Conclusion

Dietary counseling and the provision of EPA-ONS may result in maintenance of nutritional status and QOL, however randomized trials are required to evaluate the impact of EPA on toxicity from chemotherapy.

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Acknowledgments

The EPA-containing supplement (ProSure™) was provided by Abbott Australasia. Dietary analysis was provided by Xingying Weng. The Sydney University Human Nutrition Unit and the Flinder’s Medical Centre Child Nutrition Research Centre conducted the fatty acid analysis. Westmead Hospital provided the cytokine analysis.

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Authors and Affiliations

  1. Sydney Cancer Centre, Royal Prince Alfred Hospital and Concord Hospital, Sydney, Australia

    Jane A. Read, Philip J. Beale, Annabel Childs & Stephen J. Clarke

  2. Department of Medicine, Sydney University, Sydney, Australia

    Philip J. Beale & Stephen J. Clarke

  3. Human Nutrition Unit, Sydney University, Sydney, Australia

    Dianne H. Volker

  4. Department of Mathematical Sciences, University of Technology, Sydney, Australia

    Narelle Smith

  5. Department of Medicine, University of Sydney Concord Hospital, Concord, Sydney, NSW, 2137, Australia

    Stephen J. Clarke

Authors
  1. Jane A. Read
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  2. Philip J. Beale
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  4. Narelle Smith
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  5. Annabel Childs
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Correspondence to Stephen J. Clarke.

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Read, J.A., Beale, P.J., Volker, D.H. et al. Nutrition intervention using an eicosapentaenoic acid (EPA)-containing supplement in patients with advanced colorectal cancer. Effects on nutritional and inflammatory status: a phase II trial. Support Care Cancer 15, 301–307 (2007). https://doi.org/10.1007/s00520-006-0153-3

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  • DOI: https://doi.org/10.1007/s00520-006-0153-3

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