Effects of Dietary Supplementation With omega3-fatty Acids (Fish Oil) and Progressive Resistance Training on Skeletal Muscle Status in Gynaecological, Gastrointestinal and Urological Cancer Patients (SUPPORT)
SUPPORT-Study = Effects of a Dietary SUPPlementation With Omega3-fatty Acids/ Fish Oil and Progressive Resistence Training on Skeletal Muscle Status in Gynaecological, Gastrointestinal, and Urological Cancer Patients
Cancer cachexia is a common and prognostically relevant complication of advanced malignancies, characterized by systemic inflammation, increased catabolism, and reduced nutritional intake, leading to a progressive loss of skeletal muscle mass, physical performance, and quality of life. Muscle wasting negatively affects the tolerability and efficacy of oncological therapies and exacerbates distressing symptoms such as fatigue. Consequently, international guidelines recommend combined nutritional and exercise interventions as key components of supportive cancer care. However, due to treatment-related limitations, conventional exercise programs are often difficult to implement, highlighting the need for feasible, time-efficient, and individually adaptable training concepts suitable for daily life.
In addition, adequate protein-rich nutrition is essential and may be supported by targeted nutritional supplementation. Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have demonstrated anti-inflammatory effects and beneficial influences on nutritional status, quality of life, and potentially skeletal muscle mass.
The aim of the present project is to investigate, in a randomized, placebo-controlled trial, whether the combination of progressive resistance training (twice-weekly TheraBand-based exercise) and omega-3 supplementation (daily intake of 2 g EPA and 1 g DHA administered as fish oil capsules) can improve muscle status, physical performance, and patient-relevant outcomes such as quality of life, appetite, and fatigue in cancer patients at high risk of developing cancer cachexia.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Bavaria
-
Erlangen, Bavaria, Germany, 91056
- Recruiting
- Hector-Center for Nutrition, Exercise and Sports
-
Contact:
- Prof. Dr. med. Yurdagül Zopf
- Phone Number: 0049091318545220
- Email: yurdaguel.zopf@uk-erlangen.de
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients with malignant tumors undergoing curative or palliative treatment, including breast, ovarian, esophageal, pancreatic, gastric, colon, rectal, and prostate cancer, across all UICC stages
- Women and men aged 18 years or older
- ECOG performance status 0-2
Exclusion Criteria:
- Patients younger than 18 years
- Bone metastases or skeletal involvement associated with a high risk of fracture
- Pregnant or breastfeeding women
- Patients with psychiatric disorders that raise concerns regarding decision-making capacity or ability to provide informed consent
- Participation in other exercise and/or nutritional intervention studies within the previous 3 months
- Current use of fish oil supplements
- Severe cardiovascular disease, NYHA class IV
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo, no training
Placebo (corn oli) and no training program
|
4x capsueles daily
|
|
Placebo Comparator: Placebo, training group
Placebo (corn oli) and 2x weekly resistance training
|
4x capsueles daily
2x weekly resistance training
|
|
Experimental: Omega-3, no training
Verum (Omega-3-capsules with fish oil) and no training program
|
4x capsules containing 500 mg EPA and 250 mg DHA
|
|
Experimental: Omega-3, training group
Verum (Omega-3-capsules with fish oil) and 2x weekly resistance training
|
2x weekly resistance training
4x capsules containing 500 mg EPA and 250 mg DHA
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Skeletal Muscle Status I
Time Frame: Baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Body composition: BIA (SMM in kg)
|
Baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Skeletal Muscle Status II
Time Frame: Baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Muscle function: Tensiomyography (TMG) (Dm in mm, Tc in ms, Td in ms, Ts in ms, Tr in ms)
|
Baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Skeletal Muscle Status III
Time Frame: Baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Maximal muscle strength: estimated one-repetition maximum (1-RM in kg)
|
Baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Skeletal Muscle Status IV
Time Frame: Baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Handgrip strength: dynamometer (in kg)
|
Baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Physical Performance I
Time Frame: baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Functional exercise capacity: 6-minute walk test (distance in m)
|
baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Physical Performance II
Time Frame: baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Daily physical activity: International Physical Activity Questionnaire (IPAQ)
|
baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Physical Performance III
Time Frame: baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Accelerometry over 7 consecutive days (steps)
|
baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Nutritional Status I
Time Frame: baseline, 3 weeks, 6 weeks, 9 weeks, 12 weeks, 6 months follow-up after study completion
|
Malnutrition screening: Nutritional Risk Screening Score (NRS 2002) [0 (no risk) - 7 (highest risk)]
|
baseline, 3 weeks, 6 weeks, 9 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Nutritional Status II
Time Frame: baseline, 3 weeks, 6 weeks, 9 weeks, 12 weeks, 6 months follow-up after study completion
|
Dietary intake and nutrient analysis: 3 or 7-day dietary record for assessment of energy and protein intake (in g)
|
baseline, 3 weeks, 6 weeks, 9 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Nutritional Status III
Time Frame: baseline, 3 weeks, 6 weeks, 9 weeks, 12 weeks, 6 months follow-up after study completion
|
Dietary intake and nutrient analysis: 3 or 7-day dietary record and assessment of consumption of EPA- and DHA-rich foods, and omega-3/omega-6 fatty acid ratio (in g)
|
baseline, 3 weeks, 6 weeks, 9 weeks, 12 weeks, 6 months follow-up after study completion
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Patient-Reported Outcomes I
Time Frame: baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Appetite perception: VAS-scale (Visual Analog Scale 0 [none] - 10 [excessive])
|
baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Patient-Reported Outcomes II
Time Frame: baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Quality of life: European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30)
|
baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Patient-Reported Outcomes III
Time Frame: baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Fatigue: The Functional Assessment of Chronic Illness Therapy (FACIT) - Scale [0-52, higher scores indicate better quality of life and less severe fatigue]
|
baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Patient-Reported Outcomes III
Time Frame: baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Symptom burden and treatment-related side effects: Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)
|
baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Patient-Reported Outcomes IV
Time Frame: baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Edmonton Symptom Assessment Scale (ESAS) [0 (none) - 10 (worst possible)]
|
baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
|
Omega-3-Index
Time Frame: baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Laboratory Endpoints: Omega-3 Fatty Acid Status as Blood-Based Biomarkers
|
baseline, 6 weeks, 12 weeks, 6 months follow-up after study completion
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Yurdagül Zopf, Prof. Dr. med., Universitätsklinikum Erlangen
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
- Quality of life
- Fatigue
- Eicosapentaenoic acid (EPA)
- Docosahexaenoic acid (DHA)
- Omega-3 fatty acids
- Exercise therapy
- Appetite
- Resistance training
- Nutritional supplementation
- Patient-reported outcomes
- Physical performance
- Supportive cancer care
- Nutritional intervention
- Fish oil supplementation
- Randomized placebo-controlled trial
- Progressive resistance exercise
- Protein-rich nutrition
- Cachexia risk
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- SUPPORT-Study
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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