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Tytuł:
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Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy.
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Autorzy:
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Cereda E; Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Turri A; Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Klersy C; Biometry and Clinical Epidemiology Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Cappello S; Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Ferrari A; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Filippi AR; Radiation Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Brugnatelli S; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Caraccia M; Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Chiellino S; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Borioli V; Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Monaco T; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Stella GM; Unit of Respiratory System Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Arcaini L; Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.; Department of Molecular Medicine, University of Pavia, Pavia, Italy.
Benazzo M; Department of Otolaryngology, University of Pavia, Pavia, Italy.; Head Neck Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Grugnetti G; Nursing Technical and Rehabilitation Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Pedrazzoli P; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.; Department of Internal Medicine, University of Pavia, Pavia, Italy.
Caccialanza R; Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
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Źródło:
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Cancer medicine [Cancer Med] 2019 Nov; Vol. 8 (16), pp. 6923-6932. Date of Electronic Publication: 2019 Sep 30.
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Typ publikacji:
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Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: [Malden, MA] : John Wiley & Sons Ltd., c2012-
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MeSH Terms:
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Dietary Supplements*
Malnutrition/*diet therapy
Neoplasms/*diet therapy
Whey Proteins/*therapeutic use
Aged ; Antineoplastic Agents/therapeutic use ; Body Composition ; Female ; Humans ; Male ; Middle Aged ; Muscle Strength ; Neoplasms/drug therapy
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References:
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Grant Information:
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International Fondazione IRCCS Policlinico San Matteo; International Italian Ministry of Health; 08067617 International Ricerca Corrente; International Difass International srl.
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Contributed Indexing:
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Keywords: cancer; malnutrition; nutritional counseling; whey proteins
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Molecular Sequence:
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ClinicalTrials.gov NCT02065726
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Substance Nomenclature:
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0 (Antineoplastic Agents)
0 (Whey Proteins)
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Entry Date(s):
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Date Created: 20191001 Date Completed: 20200924 Latest Revision: 20210110
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Update Code:
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20240105
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PubMed Central ID:
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PMC6853834
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DOI:
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10.1002/cam4.2517
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PMID:
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31568698
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In recent years, whey proteins (WP) have attracted increasing attention in health and disease for their bioactive functions. The aim of this study was to evaluate the benefit of WP isolate (WPI) supplementation in addition to nutritional counseling in malnourished advanced cancer patients undergoing chemotherapy (CT). In a single-center, randomized, pragmatic, and parallel-group controlled trial (ClinicalTrials.gov: NCT02065726), 166 malnourished advanced cancer patients with mixed tumor entities candidate to or undergoing CT were randomly assigned to receive nutritional counseling with (N = 82) or without (N = 84) WPI supplementation (20 g/d) for 3 months. The primary endpoint was the change in phase angle (PhA). Secondary endpoints included changes in standardized PhA (SPA), fat-free mass index (FFMI), body weight, muscle strength, and CT toxicity (CTCAE 4.0 events). In patients with the primary endpoint assessed (modified intention-to-treat population), counseling plus WPI (N = 66) resulted in improved PhA compared to nutritional counseling alone (N = 69): mean difference, 0.48° (95% CI, 0.05 to 0.90) (P = .027). WPI supplementation also resulted in improved SPA (P = .021), FFMI (P = .041), body weight (P = .023), muscle strength (P < .001), and in a reduced risk of CT toxicity (risk difference, -9.8% [95% CI, -16.9 to -2.6]; P = .009), particularly of severe (grade ≥ 3) events (risk difference, -30.4% [95% CI, -44.4 to -16.5]; P = .001). In malnourished advanced cancer patients undergoing CT, receiving nutritional counseling, a 3-month supplementation with WPI resulted in improved body composition, muscle strength, body weight, and reduced CT toxicity. Further trials, aimed at verifying the efficacy of this nutritional intervention on mid- and long-term primary clinical endpoints in newly diagnosed specific cancer types, are warranted.
(© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
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