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Home > Vol 40, No 3 (2022) > Rogers

Acceptability, Compliance, and Safety of Non-small Cell Lung Cancer Cachectic Participants Continuing Compassionate Access in the ACCeRT Clinical Study

Elaine S Rogers, Rita Sasidharan, Graeme M Sequeira, Matthew R Wood, Stephen P Bird, Justin W L Keogh, Bruce Arroll, Joanna Stewart, Roderick D MacLeod

Abstract

Objective: Cancer cachexia is defined as: a ‘multifactorial syndrome’, and it has been suggested that a multitargeted approach is required in its management. High prevalence is seen within non-small cell lung cancer, and patients may continue to experience cachexia post end of anti-cancer treatment, and in the late/end stage.
Material and Methods: Participants who had completed week 20/End of Trial visit in the main Auckland’s Cancer Cachexia evaluating Resistance Training (ACCeRT) study were invited to continue with treatment under compassionate use. Participants could continue with 2.09 g of eicosapentaenoic acid (EPA), 300 mg COX-2 inhibitor (celecoxib), once daily; plus two sessions per week of progressive resistance training (PRT), and 20 g oral essential amino acids (EAA); high in leucine, in a split dose over three days post each session. Data was collected on the acceptability, compliance and adherence to medication/PRT sessions. Secondary endpoints included: change in body weight and fat free mass, handgrip and leg strength, the Functional Assessment of Anorexia/Cachexia Therapy, Multidimensional Fatigue Symptom Inventory-Short Form, World Health Organization Quality of Life — BREF, Glasgow prognostic score, and pro-inflammatory cytokines.
Results: All six participants, who completed the main ACCeRT study, opted to continue with compassionate use. Acceptability remained high, with overall compliance to last study/PRT visit of 81.0% for EPA, 98.8% for celecoxib, 78.9% for PRT and 77.2% for EAA. Participants continued to lose body weight and Fat-Free Mass, along with reduced albumin and increased C-Reactive protein levels. Mean time on compassionate study treatment was 78 days, and with a mean overall survival of 257 days (140 + 117).
Conclusion: Non-small cell lung cancer (NSCLC) cachectic patients are willing to be enrolled onto a multi-targeted treatment regimen, and may benefit from cachexia symptom management even during their late/refractory stage.

 Keywords

Refractory cancer cachexia; Resistance Training; NSCLC cachectic patients; multi-targeted treatment

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DOI: http://dx.doi.org/10.31584/jhsmr.2021842

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2020
Acceptance rate: 52%
2021
Acceptance rate: 27.8%
2022 (March)
Acceptance rate: 15.6%
2023 (June)
Acceptance rate: 23.6%
2024 (June)
Acceptance rate: 19%


Submission to final decision
74 days

Acceptance to publication
40 days

0.6
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31st percentile
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About The Authors

Elaine S Rogers
Department of General Practice and Primary Health Care, University of Auckland, Auckland, 1142 New Zealand. Department of Medical Oncology, Auckland City Hospital, Auckland, 1023
New Zealand

Rita Sasidharan
Department of Medical Oncology, Auckland City Hospital, Auckland, 1023
New Zealand

Graeme M Sequeira
School of Sport, Manukau Institute of Technology, Auckland, 2241
New Zealand

Matthew R Wood
Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, 1010
New Zealand

Stephen P Bird
Department of Medical and Exercise Science, University of Wollongong, New South Wales, 2522
Australia

Justin W L Keogh
Faculty of Health Sciences and Medicine, Bond University, Gold Coast, 4226
Australia

Bruce Arroll
Department of General Practice and Primary Health Care, University of Auckland, Auckland, 1142
New Zealand

Joanna Stewart
Department of Epidemiology and Biostatistics, University of Auckland, Auckland, 1142
New Zealand

Roderick D MacLeod
Northern Clinical School, University of Sydney, Sydney, New South Wales, 2065
Australia

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