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dc.contributor.authorBrown, Leo R.
dc.contributor.authorSousa, Mariana S.
dc.contributor.authorYule, Michael S.
dc.contributor.authorBaracos, Vickie E.
dc.contributor.authorMcMillan, Donald C.
dc.contributor.authorArends, Jann
dc.contributor.authorBalstad, Trude Rakel
dc.contributor.authorBye, Asta
dc.contributor.authorDajani, Olav
dc.contributor.authorDolan, Ross D.
dc.contributor.authorFallon, Marie T.
dc.contributor.authorGreil, Christine
dc.contributor.authorHjermstad, Marianne Jensen
dc.contributor.authorJakobsen, Gunnhild
dc.contributor.authorMaddocks, Matthew
dc.contributor.authorMcDonald, James
dc.contributor.authorOttestad, Inger
dc.contributor.authorPhillips, Iain
dc.contributor.authorSayers, Judith
dc.contributor.authorSimpson, Melanie Rae
dc.contributor.authorVagnildhaug, Ola Magne
dc.contributor.authorSolheim, Tora S
dc.contributor.authorLaird, Barry J
dc.contributor.authorSkipworth, Richard J.E.
dc.date.accessioned2024-09-25T08:36:17Z
dc.date.available2024-09-25T08:36:17Z
dc.date.issued2024-05-13
dc.description.abstractSignificant variation exists in the outcomes used in cancer cachexia trials, including measures of body composition, which are often selected as primary or secondary endpoints. To date, there has been no review of the most commonly selected measures or their potential sensitivity to detect changes resulting from the interventions being examined. The aim of this systematic review is to assess the frequency and diversity of body composition measures that have been used in cancer cachexia trials. MEDLINE, Embase and Cochrane Library databases were systematically searched between January 1990 and June 2021. Eligible trials examined adults (≥18 years) who had received an intervention aiming to treat or attenuate the effects of cancer cachexia for >14 days. Trials were also of a prospective controlled design and included body weight or at least one anthropometric, bioelectrical or radiological endpoint pertaining to body composition, irrespective of the modality of intervention (e.g., pharmacological, nutritional, physical exercise and behavioural) or comparator. Trials with a sample size of <40 patients were excluded. Data extraction used Covidence software, and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. This review was prospectively registered (PROSPERO: CRD42022276710). A total of 84 clinical trials, comprising 13 016 patients, were eligible for inclusion. Non-small-cell lung cancer and pancreatic cancer were studied most frequently. The majority of trial interventions were pharmacological (52%) or nutritional (34%) in nature. The most frequently reported endpoints were assessments of body weight (68 trials, n = 11 561) followed by bioimpedance analysis (BIA)-based estimates (23 trials, n = 3140). Sixteen trials (n = 3052) included dual-energy X-ray absorptiometry (DEXA)-based endpoints, and computed tomography (CT) body composition was included in eight trials (n = 841). Discrepancies were evident when comparing the efficacy of interventions using BIA-based estimates of lean tissue mass against radiological assessment modalities. Body weight, BIA and DEXA-based endpoints have been most frequently used in cancer cachexia trials. Although the optimal endpoints cannot be determined from this review, body weight, alongside measurements from radiological body composition analysis, would seem appropriate. The choice of radiological modality is likely to be dependent on the trial setting, population and intervention in question. CT and magnetic resonance imaging, which have the ability to accurately discriminate tissue types, are likely to be more sensitive and provide greater detail. Endpoints are of particular importance when aligned with the intervention’s mechanism of action and/or intended patient benefit.en_US
dc.identifier.citationBrown, Sousa, Yule, Baracos, McMillan, Arends, Balstad, Bye, Dajani, Dolan, Fallon, Greil, Hjermstad, Jakobsen, Maddocks, McDonald, Ottestad, Phillips, Sayers, Simpson, Vagnildhaug, Solheim, Laird, Skipworth. Body weight and composition endpoints in cancer cachexia clinical trials: Systematic Review 4 of the cachexia endpoints series. Journal of Cachexia, Sarcopenia and Muscle. 2024
dc.identifier.cristinIDFRIDAID 2272154
dc.identifier.doi10.1002/jcsm.13478
dc.identifier.issn2190-5991
dc.identifier.issn2190-6009
dc.identifier.urihttps://hdl.handle.net/10037/34860
dc.language.isoengen_US
dc.publisherWileyen_US
dc.relation.journalJournal of Cachexia, Sarcopenia and Muscle
dc.rights.holderCopyright 2024 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleBody weight and composition endpoints in cancer cachexia clinical trials: Systematic Review 4 of the cachexia endpoints seriesen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's license is described as Attribution 4.0 International (CC BY 4.0)