Adenosine triphosphate improves nutritional status in lung cancer patients

By Will Boggs, MD

NEW YORK (Reuters Health) – The use of adenosine 5'-triphosphate (ATP) results in improved energy intake and reduced muscle wasting in patients with advanced lung cancer, according to a report in the January 15th Journal of Clinical Oncology.

ATP was previously shown in a controlled clinical trial to induce maintenance of body weight, muscle strength, quality of life, and serum albumin levels in patients with advanced non-small-cell lung cancer (NSCLC), the authors explain.

Dr. Pieter C. Dagnelie, from Maastricht University in the Netherlands, and colleagues extend the results of the earlier study by analyzing the effects of ATP infusions at 2- to 4-week intervals on body composition, energy intake, and energy expenditure in the same population of 58 patients with advanced NSCLC.

Fat-free mass showed no significant change in ATP-treated patients, the authors report, whereas the control group experienced a significant drop in fat-free mass after the first 16 weeks of the trial.

Mid-upper-arm muscle area increased by 1.1% in the ATP group, the results indicate, but decreased by 1.8% in the control group (p = 0.02).

The control group also showed a significant decline in body cell mass and a highly significant decrease in energy intake, the researchers note, but ATP-treated patients experienced no change in body cell mass and a nonsignificant increase in energy intake.

Appetite did not change in the ATP group, the report indicates, but deteriorated in the control group.

Resting energy expenditure did not differ between the two groups, the investigators say.

"ATP may be the first agent able to deal with the problem of loss of muscle mass in cancer cachexia," Dr. Dagnelie told Reuters Health, "whereas previous modalities such as Megace or corticosteroids usually only stimulated appetite or gain of fat mass, but not muscle mass."

"It now appears that a solution for the cancer-cachexia problem may be within the reach of any physician in the very near future," Dr. Dagnelie concluded.

"This is just one trial which needs confirmation by at least one or two other trials," Dr. Dagnelie cautioned. "More importantly, some important questions, such as dosing schedule, have not yet been adequately dealt with, and there are side effects of ATP infusion which are harmless if adequately handled under medical supervision, but potentially harmful if not."

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