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Cancer cachexia, a serious condition causing muscle loss, may be treated with a multimodal approach. The MENAC trial investigates exercise, nutrition, and anti-inflammatory drugs for this complex syndrome.

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Area of Science:

  • Oncology
  • Metabolism
  • Gerontology

Background:

  • Cancer cachexia is a prevalent syndrome characterized by significant skeletal muscle mass loss.
  • It severely impacts patient function, morbidity, and mortality, with no current licensed treatments.
  • The multifactorial nature of cachexia suggests a multimodal therapeutic strategy.

Purpose of the Study:

  • To describe the development of the phase III MENAC trial for cancer cachexia.
  • To outline a multimodal intervention combining exercise, nutrition, and anti-inflammatory medication.
  • To establish a standard of care for managing cancer cachexia.

Main Methods:

  • The MENAC trial (NCT02330926) is a phase III randomized controlled trial.
  • Intervention includes non-steroidal anti-inflammatory drugs, eicosapentaenoic acid, resistance and aerobic exercise, dietary counseling, and nutritional supplements.
  • The trial aims to reduce inflammation, increase anabolism, and promote energy and protein balance.

Main Results:

  • A successful phase II trial preceded the ongoing phase III trial.
  • The intervention is based on current evidence for managing cachexia.
  • Detailed development of the trial protocol is described.

Conclusions:

  • A multimodal approach is being investigated for cancer cachexia.
  • The MENAC trial represents a significant step towards a potential standard of care.
  • This intervention targets inflammation, anabolism, and nutritional balance.