- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT07664007
Effects of EPA Supplementation on Patients With Unresectable Hepatocellular Carcinoma.
Effects of Nutritional Supplementation With Eicosapentaenoic Acid (EPA) on Body Composition and Systemic Pro-inflammatory and Pro-resolving Mediators in Patients Diagnosed With Unresectable Hepatocellular Carcinoma.
Studienübersicht
Status
Bedingungen
Detaillierte Beschreibung
Cancer-associated cachexia is a debilitating and potentially life-threatening syndrome characterized by progressive loss of body weight, skeletal muscle, and adipose tissue, leading to functional impairment and reduced response to oncologic therapy. It is driven in part by systemic inflammation and increased pro-inflammatory cytokines, and it cannot always be reversed with conventional support.
Eicosapentaenoic acid (EPA), an omega-3 polyunsaturated fatty acid (PUFA), has anti-inflammatory properties and is rapidly incorporated into cell membranes, modulating lipid mediator pathways. EPA supplementation may help to attenuate systemic inflammation, alleviate cachexia symptoms, and promote the production of specialized pro-resolving mediators. A daily dose of 3 grams appears sufficient to achieve maximal incorporation into cell membranes without significant adverse events.
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide, with most patients diagnosed at advanced stages. Cachexia is common in advanced HCC and contributes to functional decline, increased treatment toxicity, and poorer outcomes. Preclinical studies suggest that omega-3 PUFAs may also exert anti-tumor effects through modulation of COX-2 and Wnt/beta-catenin signaling pathways.
For these reasons, in this proposal, the investigators aim to determine wheter supplementation with EPA in combination with chemotherapy will modify the blood profile of pro-inflammatory and pro-resolving mediators, promoting the resolution of inflammation associated with HCC, and, in turn, mitigate muscle mass loss during oncologic treatment.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Unzutreffend
Kontakte und Standorte
Studienorte
-
-
Zaragoza
-
Zaragoza, Zaragoza, Spanien, 50009
- Hospital Clinico Universitario Lozano Blesa. IIS Aragon
-
-
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Participants diagnosed with unresectable HCC, candidates for systemic treatment with Sorafenib or similar agents.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
- Life expectancy > 8 weeks.
- Not eligible for curative treatment (surgical resection/ablative therapy/liver transplantation).
- Not having a history of previous or concomitant malignancy except when a disease-free interval > 5 years had been documented.
- Not receiving any other systemic antitumor agents (docetaxel, doxorubicin, irinotecan).
Exclusion Criteria:
- Allergy to omega-3 acid or fish-derived products.
- Psychological or medical conditions that can interfere with study participation or the ability to provide informed consent.
- Drug abuse (except for alcohol).
- Any experimental therapy within 30 days prior to study entry.
- Recurrent epistaxis
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Verdreifachen
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Experimental: Intervention group
Patients with unresectable hepatocellular carcinoma (HCC) were given 3 grams/day of an oral lipidic emulsion of eicosapentaenoic acid in addition to their oncologic care during 12 weeks.
|
1 sachet/day of 20 ml containing 3g EPA during 12 weeks
|
|
Placebo-Komparator: Control group
Patients with unresectable hepatocellular carcinoma (HCC) were given a placebo oral lipidic emulsion in addition to their oncologic care during 12 weeks.
|
1 sachet/day of 20 ml of placebo during 12 weeks
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Effect of EPA supplementation on muscle mass
Zeitfenster: At baseline, and at 12 weeks (study completion)
|
Muscle mass is assessed by calculating the skeletal muscle index using computed tomography, based on a single axial slice at the L3 level.
The SliceOmatic software (TomoVision) is used for the calculations.
Sarcopenia is evaluated using two criteria: Carey reference values for end-stage liver disease patients awaiting transplantation, and Martin reference values for oncology patients.
|
At baseline, and at 12 weeks (study completion)
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Evolution of nutritional status.
Zeitfenster: At baseline, at 6 weeks, and at 12 weeks (study completion)
|
Nutritional status is assessed using the validated Patient-Generated Subjective Global Assessment tool (PG-SGA, Bauer 2002) that classify patients as well nourished (A), moderately malnourished or at risk of malnutrition (B), or severely malnourished (C).
|
At baseline, at 6 weeks, and at 12 weeks (study completion)
|
|
Effect of EPA supplementation on quality of life assessed using the EORTC-QLQ-30.
Zeitfenster: At baseline, at 6 weeks, and at 12 weeks (study completion)
|
Quality of life is assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-30)
|
At baseline, at 6 weeks, and at 12 weeks (study completion)
|
|
Change in the quality of life assessed using the EORTC-QLQ-HCC18.
Zeitfenster: At baseline, at 6 weeks, and at 12 weeks (study completion)
|
Quality of life is assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Hepatocellular Carcinoma 18-question module (QLQ-HCC18).
|
At baseline, at 6 weeks, and at 12 weeks (study completion)
|
|
Effect of EPA supplementation on plasma and serum profiles of pro-inflammatory and pro-resolving lipid mediators.
Zeitfenster: At baseline, and at 12 weeks (study completion)
|
Plasma and serum concentrations of pro-inflammatory and pro-resolving lipid mediators derived from polyunsaturated fatty acids are determined using targeted LC-MS/MS.
|
At baseline, and at 12 weeks (study completion)
|
|
Change in C-reactive protein (CRP) concentration upon supplementation.
Zeitfenster: At baseline, and at 12 weeks (study completion)
|
The C-reactive protein is measured using an immunoturbidimetric assay following the standard laboratory methods in the Hospital Clínico Universitario Lozano Blesa.
|
At baseline, and at 12 weeks (study completion)
|
|
Change in interleukin 6 upon supplementation.
Zeitfenster: At baseline, and at 12 weeks (study completion)
|
Plasma IL-6 levels are determined by enzyme-linked immunosorbent assay.
|
At baseline, and at 12 weeks (study completion)
|
|
Change in interleukin 8 upon supplementation.
Zeitfenster: At baseline, and at 12 weeks (study completion)
|
Plasma Il-8 is quantified using the Human XL Cytokine Luminex® Kit Performance Assay (R&D Systems).
|
At baseline, and at 12 weeks (study completion)
|
|
Change in interferon gamma (IFNγ) upon supplementation.
Zeitfenster: At baseline, and at 12 weeks (study completion)
|
Plasma IFNγ is quantified using the Human XL Cytokine Luminex® Kit Performance Assay (R&D Systems).
|
At baseline, and at 12 weeks (study completion)
|
|
Change in the neutrophil-to-lymphocyte ratio (NLR) upon supplementation.
Zeitfenster: At baseline, and at 12 weeks (study completion)
|
NLR is calculated by dividing the absolute neutrophil count by the absolute lymphocyte count obtained from peripheral blood samples.
Both values were derived from the complete blood count (CBC) analysis.
|
At baseline, and at 12 weeks (study completion)
|
Mitarbeiter und Ermittler
Ermittler
- Hauptermittler: Angel Lanas Arbeloa, MD, PhD, University Hospital Lozano Blesa. IIS Aragón. CIBER de Enfermedades Hepáticas y Digestivas
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, Cohen MH, Douglass HO Jr, Engstrom PF, Ezdinli EZ, Horton J, Johnson GJ, Moertel CG, Oken MM, Perlia C, Rosenbaum C, Silverstein MN, Skeel RT, Sponzo RW, Tormey DC. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980 Oct;69(4):491-7. doi: 10.1016/s0149-2918(05)80001-3.
- Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr. 2002 Aug;56(8):779-85. doi: 10.1038/sj.ejcn.1601412.
- Fearon KC, Voss AC, Hustead DS; Cancer Cachexia Study Group. Definition of cancer cachexia: effect of weight loss, reduced food intake, and systemic inflammation on functional status and prognosis. Am J Clin Nutr. 2006 Jun;83(6):1345-50. doi: 10.1093/ajcn/83.6.1345.
- Martin L, Birdsell L, Macdonald N, Reiman T, Clandinin MT, McCargar LJ, Murphy R, Ghosh S, Sawyer MB, Baracos VE. Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol. 2013 Apr 20;31(12):1539-47. doi: 10.1200/JCO.2012.45.2722. Epub 2013 Mar 25.
- Blazeby JM, Currie E, Zee BC, Chie WC, Poon RT, Garden OJ; EORTC Quality of Life Group. Development of a questionnaire module to supplement the EORTC QLQ-C30 to assess quality of life in patients with hepatocellular carcinoma, the EORTC QLQ-HCC18. Eur J Cancer. 2004 Nov;40(16):2439-44. doi: 10.1016/j.ejca.2004.06.033.
- Ozola Zalite I, Zykus R, Francisco Gonzalez M, Saygili F, Pukitis A, Gaujoux S, Charnley RM, Lyadov V. Influence of cachexia and sarcopenia on survival in pancreatic ductal adenocarcinoma: a systematic review. Pancreatology. 2015 Jan-Feb;15(1):19-24. doi: 10.1016/j.pan.2014.11.006. Epub 2014 Dec 4.
- Carey EJ, Lai JC, Wang CW, Dasarathy S, Lobach I, Montano-Loza AJ, Dunn MA; Fitness, Life Enhancement, and Exercise in Liver Transplantation Consortium. A multicenter study to define sarcopenia in patients with end-stage liver disease. Liver Transpl. 2017 May;23(5):625-633. doi: 10.1002/lt.24750.
- Lim K, Han C, Dai Y, Shen M, Wu T. Omega-3 polyunsaturated fatty acids inhibit hepatocellular carcinoma cell growth through blocking beta-catenin and cyclooxygenase-2. Mol Cancer Ther. 2009 Nov;8(11):3046-55. doi: 10.1158/1535-7163.MCT-09-0551. Epub 2009 Nov 3.
- Ikeda T, Tozuka S, Hasumura Y, Takeuchi J. Prostaglandin-E-producing hepatocellular carcinoma with hypercalcemia. Cancer. 1988 May 1;61(9):1813-4. doi: 10.1002/1097-0142(19880501)61:93.0.co;2-u.
- Onesti JK, Guttridge DC. Inflammation based regulation of cancer cachexia. Biomed Res Int. 2014;2014:168407. doi: 10.1155/2014/168407. Epub 2014 May 4.
- Aoyagi T, Terracina KP, Raza A, Matsubara H, Takabe K. Cancer cachexia, mechanism and treatment. World J Gastrointest Oncol. 2015 Apr 15;7(4):17-29. doi: 10.4251/wjgo.v7.i4.17.
- Tazi E, Errihani H. Treatment of cachexia in oncology. Indian J Palliat Care. 2010 Sep;16(3):129-37. doi: 10.4103/0973-1075.73644.
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Pathologische Prozesse
- Neubildungen nach Standort
- Neubildungen
- Körpergewicht
- Änderungen des Körpergewichts
- Neubildungen nach histologischem Typ
- Neoplasmen des Verdauungssystems
- Erkrankungen des Verdauungssystems
- Leberkrankheiten
- Neubildungen, Drüsen und Epithelien
- Adenokarzinom
- Lebertumoren
- Karzinom
- Gewichtsverlust
- Dünnheit
- Pathologische Zustände, Anzeichen und Symptome
- Anzeichen und Symptome
- Karzinom, hepatozellulär
- Entzündung
- Kachexie
Andere Studien-ID-Nummern
- LMP225_18
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .
Klinische Studien zur Hepatozelluläres Karzinom
-
Dana-Farber Cancer InstituteMassachusetts General Hospital; Beth Israel Deaconess Medical Center; Brigham...AbgeschlossenDuktales Carcinoma in situ der BrustVereinigte Staaten
-
McMaster UniversitySt. Joseph's Healthcare Hamilton; Hamilton Health Sciences CorporationUnbekanntInvasiver Brustkrebs | Duktales Carcinoma in situ der BrustKanada
-
University of Southern CaliforniaBeendetBrustkrebsVereinigte Staaten
-
Endo PharmaceuticalsAbgeschlossen
-
Fondazione IRCCS Istituto Nazionale dei Tumori,...Abgeschlossen
-
Vanderbilt-Ingram Cancer CenterNational Cancer Institute (NCI)BeendetBrustkrebsVereinigte Staaten
-
Jeong Eon LeeNoch keine RekrutierungDuktales Carcinoma in situ der BrustSüdkorea
-
University of AarhusUnbekanntCarcinoma in situ des GebärmutterhalsesDänemark
-
Fujian Provincial HospitalRekrutierungCarcinoma in situ des zervikalen Teils der SpeiseröhreChina
-
Brookdale University Hospital Medical CenterUnbekanntCarcinoma in situ des Gebärmutterhalses | Zervikale intraepitheliale Neoplasien | Hochgradige zervikale intraepitheliale NeoplasieVereinigte Staaten
Klinische Studien zur Eicosapentaenoic acid oral lipidic emulsion
-
Unidad de Investigación Genética MolecularUniversidad de AntioquiaAbgeschlossen