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

Article


Rogers, Elaine S., Sasidharan, Rita, Sequeira, Graeme M., Wood, Matthew R., Bird, Stephen P., Keogh, Justin W. L., Arroll, Bruce, Stewart, Joanna and MacLeod, Roderick D.. 2022. "Acceptability, Compliance, and Safety of Non-small Cell Lung Cancer Cachectic Participants Continuing Compassionate Access in the ACCeRT Clinical Study." Journal of Health Science and Medical Research. 40 (3), pp. 335-347. https://doi.org/10.31584/jhsmr.2021842
Article Title

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

Article CategoryArticle
AuthorsRogers, Elaine S. (Author), Sasidharan, Rita (Author), Sequeira, Graeme M. (Author), Wood, Matthew R. (Author), Bird, Stephen P. (Author), Keogh, Justin W. L. (Author), Arroll, Bruce (Author), Stewart, Joanna (Author) and MacLeod, Roderick D. (Author)
Journal TitleJournal of Health Science and Medical Research
Journal Citation40 (3), pp. 335-347
Number of Pages13
Year2022
Place of PublicationThailand
Digital Object Identifier (DOI)https://doi.org/10.31584/jhsmr.2021842
Web Address (URL)https://www.jhsmr.org/index.php/jhsmr/article/view/842
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.

Keywordsrefractory cancer cachexia; resistance training; NSCLC cachectic patients; multi-targeted treatment
ANZSRC Field of Research 2020420199. Allied health and rehabilitation science not elsewhere classified
420899. Traditional, complementary and integrative medicine not elsewhere classified
Byline AffiliationsUniversity of Auckland, New Zealand
Auckland City Hospital, New Zealand
Manukau Institute of Technology, New Zealand
Auckland University of Technology, New Zealand
University of Wollongong
Bond University
University of Sydney
Institution of OriginUniversity of Southern Queensland
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