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

Study Type

Interventional

Enrollment (Estimated)

288

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Bavaria
      • Erlangen, Bavaria, Germany, 91056
        • Recruiting
        • Hector-Center for Nutrition, Exercise and Sports
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

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

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / 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

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

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

This is where you will find people and organizations involved with this study.

Investigators

  • Study Chair: Yurdagül Zopf, Prof. Dr. med., Universitätsklinikum Erlangen

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2026

Primary Completion (Estimated)

October 1, 2028

Study Completion (Estimated)

October 1, 2029

Study Registration Dates

First Submitted

January 14, 2026

First Submitted That Met QC Criteria

June 8, 2026

First Posted (Actual)

June 11, 2026

Study Record Updates

Last Update Posted (Actual)

June 11, 2026

Last Update Submitted That Met QC Criteria

June 8, 2026

Last Verified

January 1, 2026

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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