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一项双盲、安慰剂对照的随机 IIa 期研究:评估姜黄素治疗实体瘤癌症厌食-恶病质综合征的疗效。

A Double-Blind, Placebo-Controlled Randomized Phase IIa Study: Evaluating the Effect of Curcumin for Treatment of Cancer Anorexia-Cachexia Syndrome in Solid Cancer Patients.

机构信息

Division of Medical Oncology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand.

出版信息

Asian Pac J Cancer Prev. 2022 Jul 1;23(7):2333-2340. doi: 10.31557/APJCP.2022.23.7.2333.

Abstract

OBJECTIVE

We aim to investigate the effect of curcumin on preventing cancer anorexia-cachexia syndrome (CACS) via through mechanism of inhibition on NF-kB signal pathway. Outcome measurement for primary end point was improvement of body tissue composition, and the secondary end points were body weight and body mass index, hand grip muscle strengthening, and safety.

METHODS

This is randomized, double-blind, placebo-controlled phase ll a study, 33 patients with CACS in solid malignancy were enrolled and randomized in 1:1 to receive oral curcumin (at a dose of 800 mg twice daily) or placebo for 8 weeks.

RESULTS

All parameters of body compositions were not statistically significant different between two groups, which were consist body fat mass [-1.25(SEM 0.87) vs. +0.63(SEM 0.55); p=0.119], skeletal muscle mass [-0.35(SEM 0.60) vs.+0.33(SEM 0.42); p=0.408] and percent body fat [-0.47(SEM 0.95) vs. -0.29(SEM 0.82); p=0.893] including with basal metabolic rate [-13.47(SEM 21.94) vs. +15.30(13.76); p=0.336]. The average of weight loss was also not statistically significant different between two groups. [-1.4 kg(SEM 0.89) in curcumin vs-1.12 kg(SEM 0.73), p=0.810]. Notably, patient with curcumin had less reduction of hand-grip muscle strength on both hands [Rt. handed: -2.47 in curcumin vs. -5.36 in placebo; p=0.318] [Lt. handed: -1.98 vs. -5.43; p=0.317], and basal metabolic rate than placebo group. Most adverse events were grade 1 on both groups similarly.

CONCLUSION

Curcumin was not shown to be superior to placebo with regard to increasing the body composition in cancer patients with CACS. However, curcumin might show some clinical benefits, including slow progression of hand-grip muscle strength loss, and basal metabolic rate. Further investigations should be explored.

摘要

目的

通过抑制 NF-kB 信号通路,研究姜黄素预防癌症恶病质综合征(CACS)的作用。主要终点的结果测量是改善身体组织成分,次要终点是体重和体重指数、手握力增强和安全性。

方法

这是一项随机、双盲、安慰剂对照的 IIa 期研究,纳入了 33 名实体恶性肿瘤合并 CACS 的患者,并按 1:1 随机接受口服姜黄素(剂量为 800mg,每日 2 次)或安慰剂治疗 8 周。

结果

两组间身体成分的所有参数均无统计学差异,包括体脂肪量[-1.25(SEM 0.87)与+0.63(SEM 0.55);p=0.119]、骨骼肌量[-0.35(SEM 0.60)与+0.33(SEM 0.42);p=0.408]和体脂肪百分比[-0.47(SEM 0.95)与-0.29(SEM 0.82);p=0.893],包括基础代谢率[-13.47(SEM 21.94)与+15.30(SEM 13.76);p=0.336]。两组间平均体重减轻也无统计学差异[-1.4kg(SEM 0.89)在姜黄素组与-1.12kg(SEM 0.73),p=0.810]。值得注意的是,与安慰剂组相比,姜黄素组患者双手的握力明显减弱[右利手:姜黄素组-2.47,安慰剂组-5.36;p=0.318] [左利手:姜黄素组-1.98,安慰剂组-5.43;p=0.317],基础代谢率也低于安慰剂组。两组的大多数不良事件均为 1 级。

结论

在增加 CACS 癌症患者的身体成分方面,姜黄素与安慰剂相比没有显示出优越性。然而,姜黄素可能表现出一些临床益处,包括减缓握力丧失和基础代谢率的进展。应进一步探索。

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