Should omega-3 fatty acids be used for adjuvant treatment of cancer cachexia?

Objectives: Cancer cachexia is characterised by a progressive loss of muscle, resulting in functional impairment and shorter survival. Therefore, omega-3 has been studied for its role as an anti-cachectic therapy. This systematic review identified studies published on use of omega-3 in cancer cachexia in order to examine the potential benefit. Methods: A systematic review of the literature using PubMed and B-on databases was conducted to identify clinical trials published between 2000 and 2015, to evaluate the effect of n-3 PUFAs on nutritional features and Quality of Life in cancer cachexia. Of 140 publications, 7 were selected on the basis of their methodological quality, according to the Delphi List. The collected data was summarized and written in text format and in tables. Results: Only one study, made in pre-cachectic population, show statistically and clinically positive intervention. No benefits were observed with the 4 g EPA/day, but a potentially clinically relevant treatment effect with 2 g EPA/day. Lung tumours showed the highest CRP levels and while the weight of patients with gastrointestinal cancer increased significantly, patients with lung cancer showed no significant response. Conclusions: Future cachexia trials would likely benefit from studying a single tumour type with earlier stage disease, with probably different dosage depending on the cancer type and its inflammatory profile. (c) 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.