Acceptability, Compliance, and Safety of Non-small Cell Lung Cancer Cachectic Participants Continuing Compassionate Access in the ACCeRT Clinical Study

Authors

  • Elaine S Rogers Department of General Practice and Primary Health Care, University of Auckland, Auckland, 1142 New Zealand and Department of Medical Oncology, Auckland City Hospital, Auckland, 1023 New Zealand.
  • Rita Sasidharan Department of Medical Oncology, Auckland City Hospital, Auckland, 1023 New Zealand.
  • Graeme M Sequeira School of Sport, Manukau Institute of Technology, Auckland, 2241 New Zealand.
  • Matthew R Wood Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, 1010 New Zealand.
  • Stephen P Bird Department of Medical and Exercise Science, University of Wollongong, New South Wales, 2522 Australia.
  • Justin W L Keogh Faculty of Health Sciences and Medicine, Bond University, Gold Coast, 4226 Australia.
  • Bruce Arroll Department of General Practice and Primary Health Care, University of Auckland, Auckland, 1142 New Zealand.
  • Joanna Stewart Department of Epidemiology and Biostatistics, University of Auckland, Auckland, 1142 New Zealand.
  • Roderick D MacLeod Northern Clinical School, University of Sydney, Sydney, New South Wales, 2065 Australia.

DOI:

https://doi.org/10.31584/jhsmr.2021842

Keywords:

Refractory cancer cachexia, Resistance Training, NSCLC cachectic patients, multi-targeted treatment

Abstract

Objective: Cancer cachexia is defined as: a ‘multifactorial syndrome’, and it has been suggested that a multitargeted approach is required in its management. High prevalence is seen within non-small cell lung cancer, and patients may continue to experience cachexia post end of anti-cancer treatment, and in the late/end stage.

Material and Methods: Participants who had completed week 20/End of Trial visit in the main Auckland’s Cancer Cachexia evaluating Resistance Training (ACCeRT) study were invited to continue with treatment under compassionate use. Participants could continue with 2.09 g of eicosapentaenoic acid (EPA), 300 mg COX-2 inhibitor (celecoxib), once daily; plus two sessions per week of progressive resistance training (PRT), and 20 g oral essential amino acids (EAA); high in leucine, in a split dose over three days post each session. Data was collected on the acceptability, compliance and adherence to medication/PRT sessions. Secondary endpoints included: change in body weight and fat free mass handgrip and leg strength, the Functional Assessment of Anorexia/Cachexia Therapy, Multidimensional Fatigue Symptom Inventory-Short Form, World Health Organization Quality of Life — BREF, Glasgow prognostic score, and pro-inflammatory cytokines.

Results: All six participants, who completed the main ACCeRT study, opted to continue with compassionate use. Acceptability remained high, with overall compliance to last study/PRT visit of 81.0% for EPA, 98.8% for celecoxib, 78.9% for PRT and 77.2% for EAA. Participants continued to lose body weight and Fat-Free Mass, along with reduced albumin and increased C-Reactive protein levels. Mean time on compassionate study treatment was 78 days, and with a mean overall survival of 257 days (140 + 117).

Conclusion: Non-small cell lung cancer (NSCLC) cachectic patients are willing to be enrolled onto a multi-targeted treatment regimen, and may benefit from cachexia symptom management even during their late/refractory stage.

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Published

2021-10-05

How to Cite

1.
Rogers ES, Sasidharan R, Sequeira GM, Wood MR, Bird SP, Keogh JWL, Arroll B, Stewart J, MacLeod RD. Acceptability, Compliance, and Safety of Non-small Cell Lung Cancer Cachectic Participants Continuing Compassionate Access in the ACCeRT Clinical Study. J Health Sci Med Res [Internet]. 2021 Oct. 5 [cited 2022 Jun. 26];40(3):335-47. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/255393

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Original Article