Solheim Tora S, Laird Barry J A, Balstad Trude R, Bye Asta, Stene Guro, Baracos Vickie, Strasser Florian, Griffiths Gareth, Maddocks Matthew, Fallon Marie, Kaasa Stein, Fearon Kenneth
European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway.
Cancer Clinic, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway.
BMJ Support Palliat Care. 2018 Sep;8(3):258-265. doi: 10.1136/bmjspcare-2017-001440. Epub 2018 Feb 9.
Cancer cachexia is a multifactorial syndrome characterised by an ongoing loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support alone. Cachexia has a high prevalence in cancer and a major impact on patient physical function, morbidity and mortality. Despite the consequences of cachexia, there is no licensed treatment for cachexia and no accepted standard of care. It has been argued that the multifactorial genesis of cachexia lends itself to therapeutic targeting through a multimodal treatment. Following a successful phase II trial, a phase III randomised controlled trial of a multimodal cachexia intervention is under way. Termed the MENAC trial (Multimodal-Exercise, Nutrition and Anti-inflammatory medication for Cachexia), this intervention is based on evidence to date and consists of non-steroidal anti-inflammatory drugs and eicosapentaenoic acid to reduce inflammation, a physical exercise programme using resistance and aerobic training to increase anabolism, as well as dietary counselling and oral nutritional supplements to promote energy and protein balance. Herein we describe the development of this trial.
NCT02330926.
癌症恶病质是一种多因素综合征，其特征是骨骼肌质量持续丧失，仅靠传统营养支持无法完全逆转。恶病质在癌症患者中普遍存在，对患者的身体功能、发病率和死亡率有重大影响。尽管恶病质有诸多后果，但目前尚无获批的恶病质治疗方法，也没有公认的治疗标准。有人认为，恶病质的多因素成因适合通过多模式治疗进行靶向治疗。在一项成功的II期试验之后，一项针对恶病质的多模式干预的III期随机对照试验正在进行。该试验称为MENAC试验（恶病质的多模式运动、营养和抗炎药物试验），该干预基于目前的证据，包括使用非甾体抗炎药和二十碳五烯酸来减轻炎症，采用抗阻和有氧运动的体育锻炼计划来增加合成代谢，以及提供饮食咨询和口服营养补充剂以促进能量和蛋白质平衡。在此，我们描述该试验的开展情况。
NCT02330926。
