Effect of oral eicosapentaenoic acid on weight loss in patients with pancreatic cancer

Eicosapentaenoic acid (EPA) has been shown to modulate aspects of the infla mmatory response that may contribute to weight loss in cancer. This study a imed to evaluate the acceptability and effects of oral supplementation with high-purity EPA in weighs-losing patients with advanced pancreatic cancer. Twenty-six patients were entered into the study. EPA (95% pure) was admini stered as free acid starting at 1 g/day; the dose was increased to 6 g/day over four weeks, and then a maintenance dose of 6 g/day was administered. P atients were assessed before EPA and at 4, 8, and 12 weeks while receiving EPA, for weight, body composition, hematologic and clinical chemistry varia bles, acute-phase protein response, and performance status. Overall surviva l was noted. Supplementation was well tolerated, with only five patients ex periencing side effects possibly attributable to the EPA. Before starting E PA, all patients had been losing weight at a median rate of 2 kg/mo. In gen eral, after EPA supplementation, weight was stable. After four weeks of EPA supplementation, patients had a median weight gain of 0.5 kg (p = 0.0009 v s. rate of weight loss at baseline), and this stabilization of weight persi sted over the 12-week study period. Total body water as a percentage of bod y weighs remained stable, as did the proportion of patients with an acute-p hase protein response, patients' nutritional intake, and performance status . Overall median survival from diagnosis in this study was 203 days. This s tudy suggests that EPA is well tolerated, may stabilize weight in cachectic pancreatic cancer patients, and should be tested as an anticachectic agent in controlled trials.