Patients with lung cancer who received daily fish oil supplements experienced greater tumor shrinkage during chemotherapy and longer overall survival (OS) and were less likely to lose weight than patients taking placebo. The study was led by Vera Mazurak, PhD, an expert in nutrition and metabolism with the Department of Agricultural, Food and Nutritional science at the University of Alberta in Canada.
In the first half of the 2-part study, investigators enrolled 46 patients with non-small cell lung cancer who were undergoing chemotherapy and randomized 15 patients to take daily fish oil supplements. The remaining 31 patients made up the control group. According to Mazurak, tumors shrank in 60% of patients given fish oil supplements; only 28.5% of the control group experienced a similar measure of tumor reduction.
The second part of the study enrolled 40 patients, 16 of whom took 2.2 g of eicosapentaenoic acid (EPA) daily for an average of 10 weeks. For 69% of patients in the EPA group, computed tomography scanning showed that muscle mass increased or remained the same, whereas only 29% of patients in the control group maintained muscle mass throughout chemotherapy (P = .05). On average, patients in the control group lost 1 kg of muscle and 2.3 kg overall. For some patients, muscle mass declined more than 5 kg from baseline. Patients who gained the most muscle mass had the highest concentrations of EPA in their plasma (P = .01) at the study’s conclusion.
In this second half of the study, rates of response to chemotherapy were similar between both groups. A total of 11 patients (69%) taking fish oil achieved stable disease or partial response compared with 16 patients (67%) who did not receive the supplements.
The investigators note that fish oil is nontoxic and rarely associated with adverse effects. None of the patients in the study experienced serious adverse events.
Earlier studies disagree on whether patients with cancer can benefit from EPA supplementation. Mazurak and colleagues identified 3 phase III trials examining EPA supplementation in a large number of patients that showed no beneficial effect on weight or muscle preservation. In contrast, some studies have produced similar results to those seen in the Canadian trial, with advanced cancer patients taking >2 g of EPA daily managing to maintain their weight and lean tissue mass and having better OS.
Based on the results of this small trial, however, Mazurak and colleagues said further study is warranted to determine whether EPA supplementation helps prevent cachexia in patients with cancer. The full data appear in Cancer.
Murphy RA, Mourtzakis M, Chu QSC, et al. Nutritional intervention with fish oil provides a benefit over standard of care for weight and skeletal muscle mass in patient with nonsmall cell lung cancer receiving chemotherapy. Cancer. 2011. doi:10.1002/cncr.25709.