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Effect of n-3 fatty acids on patients with advanced lung cancer: a double-blind, placebo-controlled study

  • Concetta Finocchiaro (a1), Olivia Segre (a1), Maurizio Fadda (a1), Taira Monge (a1), Mara Scigliano (a1), Marina Schena (a2), Marco Tinivella (a3), Elisa Tiozzo (a3), Maria G. Catalano (a4), Mariateresa Pugliese (a4), Nicoletta Fortunati (a5), Manuela Aragno (a6), Giuliana Muzio (a6), Marina Maggiora (a6), Manuela Oraldi (a6) and Rosa A. Canuto (a6)...


PUFA from fish oil appear to have anti-inflammatory and anti-oxidative effects and improve nutritional status in cancer patients. With this as background, the aim of the present study was to investigate the effect of EPA plus DHA on inflammatory condition, and oxidative and nutritional status in patients with lung cancer. In our multicentre, randomised, double-blind trial, thirty-three patients with a diagnosis of advanced inoperable non-small-cell lung cancer and undergoing chemotherapy were divided into two groups, receiving four capsules/d containing 510 mg of EPA and 340 mg of DHA, or 850 mg of placebo, for 66 d. At the start of chemotherapy (T0), after 8 d (T1), 22 d (T2) and 66 d (T3), biochemical (inflammatory and oxidative status parameters) and anthropometric parameters were measured in both groups. A significant increase of body weight in the n-3 group at T3v. T0 was observed. Concerning inflammation, C-reactive protein and IL-6 levels differed significantly between the n-3 and placebo groups at T3, and progressively decreased during chemotherapy in the n-3 group, evidencing n-3 PUFA anti-inflammatory action. Concerning oxidative status, plasma reactive oxygen species levels increased in the placebo group v. the n-3 group at the later treatment times. Hydroxynonenal levels increased in the placebo group during the study, while they stabilised in the n-3 group. Our data confirm that the continual assumption of EPA plus DHA determined an anti-inflammatory and anti-oxidative action which could be considered a preliminary goal in anti-cachectic therapy.

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Corresponding author

*Corresponding author: C. Finocchiaro, fax +39 011679477, email


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1Ross, JA, Moses, AGW & Fearon, KCH (1999) The anti-catabolic effect of n-3 fatty acids. Curr Opin Clin Nutr Metab Care 2, 219226.
2De Leiris, J, De Lorgeril, M & Boucher, F (2009) Fish oil and heart health. J Cardiovasc Pharmacol 54, 378384.
3Mayer, K & Seeger, W (2008) Fish oil in critical illness. Curr Opin Clin Nutr Metab Care 11, 121127.
4Singer, P & Shapiro, H (2009) Enteral omega-3 in acute respiratory distress syndrome. Curr Opin Clin Nutr Metab Care 12, 123128.
5Holub, BJ (2009) Docosahexaenoic acid (DHA) and cardiovascular disease risk factors. Prostaglandins Leukot Essent Fatty Acids 81, 199204.
6Friesecke, S, Lotze, C, Kohler, J, et al. (2008) Fish oil supplementation in the parenteral nutrition of critically ill medical patients: a randomised controlled trials. Intensive Care Med 34, 14111420.
7Colomer, R, Moreno-Nogueira, J, Garcia-Luna, P, et al. (2007) n-3 fatty acids, cancer and cachexia: a systematic review on the literature. Br J Nutr 97, 823831.
8Evans, WJ, Morley, JE, Argiles, J, et al. (2008) Cachexia: a new definition. Clin Nutr 27, 203209.
9Fearon, KC, Von Meyenfeldt, MF, Moses, AGW, et al. (2003) Effect of a protein and energy dense n-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut 52, 14791486.
10Bruera, E, Strasser, F, Palmer, JL, et al. (2003) Effect of fish oil on appetite and other symptoms in patient with advanced cancer and anorexia/cachexia: a double-blind, placebo-controlled study. J Clin Oncol 21, 129134.
11Calder, PC (2009) Polyunsatured fatty acids and inflammatory processes: new twists in an old tale. Biochimie 91, 791795.
12Whitehouse, AS & Tisdale, MJ (2003) Increased expression of the ubiquitin-proteasome pathway in murine myotubes by proteolisis-inducing factor (PIF) is associated with activation of the transcription factor NK-κB. Br J Cancer 89, 11161122.
13Calder, PC (2007) Immunomodulation by omega-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids 77, 327335.
14Jho, DH, Cole, SM, Lee, EM, et al. (2004) Role of omega-3 fatty acid supplementation in inflammation and malignancy. Integr Cancer Ther 3, 98111.
15Martin, F, Santolaria, F, Batista, N, et al. (1999) Cytokine levels (IL-6 and INF-gamma), acute phase response and nutritional status as prognostic factors in lung cancer. Cytokine 11, 8086.
16Simons, JP, Schols, AM, Buurman, WA, et al. (1999) Weight loss and low body cell mass in males with lung cancer: relationship with systemic inflammation, acute-phase response, resting energy expenditure, and catabolic and anabolic hormones. Clin Sci (Lond) 97, 125–123.
17Fearon, KC, Barber, MD, Moses, AG, et al. (2006) Double-Blind, placebo-controlled, randomized study of eicosapentaenoic acid diester in patients with cancer cachexia. J Clin Oncol 24, 34013407.
18McLean, CH, Newberry, SJ, Mojica, WA, et al. (2006) Effects of omega-3 fatty acids on cancer risk, a systematic review. JAMA 295, 403415.
19Dewey, A, Baughan, C, Dean, TP, et al. (2009) Eicosapentaenoic acid (EPA, an omega-3 fatty acid from fish oils) for the treatment of cancer cachexia. Cochrane Database Syst Rev 24, CD004597.
20Prior, WA (1997) Cigarette smoke radicals and the role of free radicals in chemical carcinogenity. Environ Health Perspect 105, 875882.
21Mossman, BT & Gee, JB (1998) Asbestosis-related disease. N Engl J Med 320, 17211730.
22Hardman, WE (2002) Omega-3 fatty acids to augment cancer therapy. J Nutr 132, 3508S3511S.
23Burns, CP, Halabi, S, Clamon, G, et al. (2004) Phase II study of high-dose fish oil capsules for patients with cancer-related cachexia. Cancer 101, 370378.
24Larsson, SC, Kumlin, M, Ingelman-Sundberg, M, et al. (2004) Dietary long-chain n-3 fatty acids for prevention of cancer: a review of potential mechanisms. Am J Clin Nutr 79, 935945.
25Mantovani, G, Macciò, A, Lai, P, et al. (1998) Cytokine activity in cancer-related anorexia/cachexia: role of megestrol acetate and medroxyprogesterone acetate. Semin Oncol 25, 4552.
26Weijl, NI, Cleton, FJ & Osanto, S (1997) Free radicals and antioxidants in chemotherapy-induced toxicity. Cancer Treat Rev 23, 209240.
27Detsky, AS, Smalley, PS & Chang, J (1994) The rational clinical examination. Is this patients malnourished? JAMA 271, 150157.
28Food Composition Tables (2000) National Research Institute for Food and Nutrition (INRAN).
29Trombetta, A, Maggiora, M, Martinasso, G, et al. (2007) Arachidonic and docosahexaenoic acids reduce the growth of A549 human lung-tumor cells increasing lipid peroxidation and PPARs. Chem Biol Interact 165, 239520.
30Ravindranath, V (1994) Animal models and molecular markers for cerebral ischemia-reperfusion injury in brain. Methods Enzymol 233, 610619.
31Esterbauer, H, Schaur, RJ & Zollner, H (1991) Chemistry and biochemistry of 4-hydroxynonenal, malonaldehyde and related aldehydes. Free Radic Biol Med 11, 81128.
32Ravasco, P, Monteiro-Grillo, I, Marques, VP, et al. (2005) Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck 27, 659668.
33Ross, PJ, Ashley, S, Norton, A, et al. (2004) Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancer? Br J Cancer 90, 19051911.
34Jatoi, A (2005) Ω-3 fatty acid supplementation for cancer-associated weight loss. Nutr Clin Pract 20, 394399.
35Staal-van den Brekel, AJ, Dentener, MA, Schols, AM, et al. (1995) Increased resting energy expenditure and weight loss are related to a systemic inflammatory response in lung cancer patients. J Clin Oncol 13, 26002605.
36Moses, AW, Slater, C, Preston, T, et al. (2004) Reduced total energy expenditure and physical activity in cachectic patients with pancreatic cancer can be modulated by an energy and protein dense oral supplementation enriched with n-3 fatty acids. Br J Cancer 90, 9961002.
37Brown, T, Zelnik, D & Dobs, A (2003) Fish oil supplementation in the treatment of cachexia in pancreatic cancer patients. Int J Gastrointest Cancer 34, 143150.
38Guarcello, M, Riso, S, Buosi, R, et al. (2007) EPA-enriched oral nutritional support in patients with lung cancer: effects on nutritional status and quality of life. Nutr Ther Metab 25, 2530.
39Elia, M, Van Bokhorst-de van der Schueren, MA, Garvey, J, et al. (2006) Enteral (oral or tube administration) nutritional support and eicosapentanoic acid in patients with cancer: a systematic review. Int J Oncol 28, 523.
40Barber, MD, Ross, JA, Voss, AC, et al. (1999) The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer. Br J Cancer 81, 8086.
41Barber, MD, Mc Millan, DC, Preston, T, et al. (2000) Metabolic response to feeding in weight-losing pancreatic cancer patients and its modulation by a fish-oil-enriched nutritional supplement. Clin Sci (Lond) 98, 389399.
42Wigmore, SJ, Barber, MD, Ross, JA, et al. (2000) Effect of oral eicosapentaenoic acid on weight loss in patients with pancreatic cancer. Nutr Cancer 36, 177184.
43Van der Meij, B, Langius, J, Smit, E, et al. (2010) Oral nutritional supplements containing (n-3) polyunsaturated fatty acids affect the nutritional status of patients with stage III non-small cell lung cancer during multimodality treatment. J Nutr 140, 17741780.
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
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