EFFECTS OF MEDROXYPROGESTERONE ACETATE ON FOOD-INTAKE, BODY-COMPOSITION, AND RESTING ENERGY-EXPENDITURE IN PATIENTS WITH ADVANCED, NONHORMONE-SENSITIVE CANCER - A RANDOMIZED, PLACEBO-CONTROLLED TRIAL

BACKGROUND. Anorexia and cachexia are well-known sequelae of cancer th at contribute to morbidity and mortality. In several studies in patien ts with non-hormone-sensitive tumors, synthetic progestogens were show n to exert beneficial effects on appetite and weight loss. The current study was undertaken to investigate the effects of medroxyprogesteron e acetate (MPA) on food intake, body composition, and resting energy e xpenditure (REE). METHODS. Fifty-four patients with non-hormone-sensit ive cancer, generally characterized by substantial weight loss and hyp ermetabolism, received either MPA, 500 mg, or placebo twice daily for 12 weeks (double-blind study). Food intake was measured by dietary his tory, body composition was assessed by deuterium dilution (fat mass, f at-free mass), and REE was obtained by indirect calorimetry. RESULTS. Compared with placebo, 12 weeks of MPA led to an increase in energy in take (between-group difference, 426 kcal/day; P = 0.01) that was signi ficantly associated (r = 0.68, P = 0.003) with an increase in fat mass (between-group difference, 2.5 kg; P = 0.009). Fat-free mass was not significantly influenced. REE increased during MPA treatment: at 6 wee ks, the between-group difference in change was 135 kcal/day (P = 0.009 ); after 12 weeks, this difference was 93 kcal/day (P = 0.07). CONCLUS IONS. The authors conclude that MPA is able to stimulate increased foo d intake significantly and to reverse fat loss concomitantly in patien ts with non-hormone-sensitive cancer. (C) 1998 American Cancer Society .