Auckland’s Cancer Cachexia evaluating Resistance Training (ACCeRT) main study results

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

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background Cancer cachexia is a condition often seen at diagnosis, throughout anticancer treatments and in end stage non-small-cell lung cancer (NSCLC) patients.
Methods Participants with late stage NSCLC and cachexia (defined as ≥5% weight loss within 12 months) were randomly assigned 1:2 to 2·09 g of eicosapentaenoic acid (EPA) and 300 mg cyclo-oxygenase-2 (COX-2) inhibitor celecoxib orally once daily versus same dosing of EPA, celecoxib, 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. Primary endpoint was the acceptability of the above multi-targeted approach. Main secondary endpoints included change in body weight and fat-free mass (FFM), by bioelectric impedance analysis (BIA) and total quadriceps muscle volume by Magnetic Resonance Imaging (MRI) over 20 weeks.
Results Sixty-nine patients were screened resulting in 20 patients being enrolled. Acceptability scored high, with 4·5/5 (Arm A) and 5/5 (Arm B) for EPA and 5/5 for celecoxib within both Arms, and 4·8/5 for PRT sessions and 4·5/5 for EAA within Arm B, all at week 20. Results showed a net gain in BIA FFM of +1·3 kg, n=2 (Arm A), compared with +0·7 kg, n=7 (Arm B) at week 12, and -1·5 kg, n=2 (Arm A), compared with ˗1·7 kg, n=4 (Arm B) at week 20. Trends in efficacy in terms of improvement and/or stability in cachexia markers were seen within MRI muscle volume, albumin and C-reactive protein levels within both Arms. There were no exercise-related adverse events, with one possible related adverse event of asymptomatic atrial fibrillation in one participant within Arm A.
Conclusion NSCLC cachectic patients are willing to be enrolled onto a multi-targeted treatment regimen and may benefit from cachexia symptom management even during the late/refractory stage.
Original languageEnglish
Number of pages25
JournalJournal of Cachexia, Sarcopenia and Muscle - Rapid Communication
Volume2
Issue number2
Publication statusPublished - 2019

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Celecoxib
Cachexia
Resistance Training
Eicosapentaenoic Acid
Non-Small Cell Lung Carcinoma
Essential Amino Acids
Electric Impedance
Neoplasms
Magnetic Resonance Imaging
Cyclooxygenase Inhibitors
Quadriceps Muscle
Leucine
C-Reactive Protein
Atrial Fibrillation
Adipose Tissue
Weight Loss
Albumins
Fats
Exercise
Muscles

Cite this

Rogers, Elaine S. ; Sasidharan, Rita ; Sequeira, Graeme ; Wood, Matthew R. ; Bird, Stephen P. ; Keogh, Justin W L ; Stewart, Joanna ; MacLeod, Roderick D. / Auckland’s Cancer Cachexia evaluating Resistance Training (ACCeRT) main study results. In: Journal of Cachexia, Sarcopenia and Muscle - Rapid Communication. 2019 ; Vol. 2, No. 2.
@article{012648fe59cd4f9699bed27285aa0b58,
title = "Auckland’s Cancer Cachexia evaluating Resistance Training (ACCeRT) main study results",
abstract = "Background Cancer cachexia is a condition often seen at diagnosis, throughout anticancer treatments and in end stage non-small-cell lung cancer (NSCLC) patients.Methods Participants with late stage NSCLC and cachexia (defined as ≥5{\%} weight loss within 12 months) were randomly assigned 1:2 to 2·09 g of eicosapentaenoic acid (EPA) and 300 mg cyclo-oxygenase-2 (COX-2) inhibitor celecoxib orally once daily versus same dosing of EPA, celecoxib, 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. Primary endpoint was the acceptability of the above multi-targeted approach. Main secondary endpoints included change in body weight and fat-free mass (FFM), by bioelectric impedance analysis (BIA) and total quadriceps muscle volume by Magnetic Resonance Imaging (MRI) over 20 weeks.Results Sixty-nine patients were screened resulting in 20 patients being enrolled. Acceptability scored high, with 4·5/5 (Arm A) and 5/5 (Arm B) for EPA and 5/5 for celecoxib within both Arms, and 4·8/5 for PRT sessions and 4·5/5 for EAA within Arm B, all at week 20. Results showed a net gain in BIA FFM of +1·3 kg, n=2 (Arm A), compared with +0·7 kg, n=7 (Arm B) at week 12, and -1·5 kg, n=2 (Arm A), compared with ˗1·7 kg, n=4 (Arm B) at week 20. Trends in efficacy in terms of improvement and/or stability in cachexia markers were seen within MRI muscle volume, albumin and C-reactive protein levels within both Arms. There were no exercise-related adverse events, with one possible related adverse event of asymptomatic atrial fibrillation in one participant within Arm A.Conclusion NSCLC cachectic patients are willing to be enrolled onto a multi-targeted treatment regimen and may benefit from cachexia symptom management even during the late/refractory stage.",
author = "Rogers, {Elaine S.} and Rita Sasidharan and Graeme Sequeira and Wood, {Matthew R.} and Bird, {Stephen P.} and Keogh, {Justin W L} and Joanna Stewart and MacLeod, {Roderick D.}",
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Rogers, ES, Sasidharan, R, Sequeira, G, Wood, MR, Bird, SP, Keogh, JWL, Stewart, J & MacLeod, RD 2019, 'Auckland’s Cancer Cachexia evaluating Resistance Training (ACCeRT) main study results' Journal of Cachexia, Sarcopenia and Muscle - Rapid Communication, vol. 2, no. 2.

Auckland’s Cancer Cachexia evaluating Resistance Training (ACCeRT) main study results. / Rogers, Elaine S.; Sasidharan, Rita; Sequeira, Graeme; Wood, Matthew R.; Bird, Stephen P.; Keogh, Justin W L; Stewart, Joanna; MacLeod, Roderick D.

In: Journal of Cachexia, Sarcopenia and Muscle - Rapid Communication, Vol. 2, No. 2, 2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Auckland’s Cancer Cachexia evaluating Resistance Training (ACCeRT) main study results

AU - Rogers, Elaine S.

AU - Sasidharan, Rita

AU - Sequeira, Graeme

AU - Wood, Matthew R.

AU - Bird, Stephen P.

AU - Keogh, Justin W L

AU - Stewart, Joanna

AU - MacLeod, Roderick D.

PY - 2019

Y1 - 2019

N2 - Background Cancer cachexia is a condition often seen at diagnosis, throughout anticancer treatments and in end stage non-small-cell lung cancer (NSCLC) patients.Methods Participants with late stage NSCLC and cachexia (defined as ≥5% weight loss within 12 months) were randomly assigned 1:2 to 2·09 g of eicosapentaenoic acid (EPA) and 300 mg cyclo-oxygenase-2 (COX-2) inhibitor celecoxib orally once daily versus same dosing of EPA, celecoxib, 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. Primary endpoint was the acceptability of the above multi-targeted approach. Main secondary endpoints included change in body weight and fat-free mass (FFM), by bioelectric impedance analysis (BIA) and total quadriceps muscle volume by Magnetic Resonance Imaging (MRI) over 20 weeks.Results Sixty-nine patients were screened resulting in 20 patients being enrolled. Acceptability scored high, with 4·5/5 (Arm A) and 5/5 (Arm B) for EPA and 5/5 for celecoxib within both Arms, and 4·8/5 for PRT sessions and 4·5/5 for EAA within Arm B, all at week 20. Results showed a net gain in BIA FFM of +1·3 kg, n=2 (Arm A), compared with +0·7 kg, n=7 (Arm B) at week 12, and -1·5 kg, n=2 (Arm A), compared with ˗1·7 kg, n=4 (Arm B) at week 20. Trends in efficacy in terms of improvement and/or stability in cachexia markers were seen within MRI muscle volume, albumin and C-reactive protein levels within both Arms. There were no exercise-related adverse events, with one possible related adverse event of asymptomatic atrial fibrillation in one participant within Arm A.Conclusion NSCLC cachectic patients are willing to be enrolled onto a multi-targeted treatment regimen and may benefit from cachexia symptom management even during the late/refractory stage.

AB - Background Cancer cachexia is a condition often seen at diagnosis, throughout anticancer treatments and in end stage non-small-cell lung cancer (NSCLC) patients.Methods Participants with late stage NSCLC and cachexia (defined as ≥5% weight loss within 12 months) were randomly assigned 1:2 to 2·09 g of eicosapentaenoic acid (EPA) and 300 mg cyclo-oxygenase-2 (COX-2) inhibitor celecoxib orally once daily versus same dosing of EPA, celecoxib, 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. Primary endpoint was the acceptability of the above multi-targeted approach. Main secondary endpoints included change in body weight and fat-free mass (FFM), by bioelectric impedance analysis (BIA) and total quadriceps muscle volume by Magnetic Resonance Imaging (MRI) over 20 weeks.Results Sixty-nine patients were screened resulting in 20 patients being enrolled. Acceptability scored high, with 4·5/5 (Arm A) and 5/5 (Arm B) for EPA and 5/5 for celecoxib within both Arms, and 4·8/5 for PRT sessions and 4·5/5 for EAA within Arm B, all at week 20. Results showed a net gain in BIA FFM of +1·3 kg, n=2 (Arm A), compared with +0·7 kg, n=7 (Arm B) at week 12, and -1·5 kg, n=2 (Arm A), compared with ˗1·7 kg, n=4 (Arm B) at week 20. Trends in efficacy in terms of improvement and/or stability in cachexia markers were seen within MRI muscle volume, albumin and C-reactive protein levels within both Arms. There were no exercise-related adverse events, with one possible related adverse event of asymptomatic atrial fibrillation in one participant within Arm A.Conclusion NSCLC cachectic patients are willing to be enrolled onto a multi-targeted treatment regimen and may benefit from cachexia symptom management even during the late/refractory stage.

M3 - Article

VL - 2

JO - Journal of Cachexia, Sarcopenia and Muscle - Rapid Communication

JF - Journal of Cachexia, Sarcopenia and Muscle - Rapid Communication

IS - 2

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