Supplementation with fish oil increases first‐line chemotherapy efficacy in patients with advanced nonsmall cell lung cancer

• Published in: Cancer Vol. 117; no. 16; pp. 3774 - 3780
• Main Authors: Murphy, Rachel A., Mourtzakis, Marina, Chu, Quincy S. C., Baracos, Vickie E., Reiman, Tony, Mazurak, Vera C.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15-08-2011; Wiley-Blackwell
• Subjects: Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; carboplatin; Carboplatin - administration & dosage; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - mortality; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Dietary Supplements; Docosahexaenoic Acids - blood; Eicosapentaenoic Acid - blood; Fatty Acids, Omega-3 - therapeutic use; Female; Humans; lung cancer; Lung Neoplasms - drug therapy; Male; Medical sciences; Middle Aged; n‐3 fatty acids; Pneumology; response rate; survival; toxicity; Tumors; Tumors of the respiratory system and mediastinum; Vinblastine - administration & dosage; Vinblastine - analogs & derivatives; Antineoplastic agent; Toxicity; Lung cancer; Lipids; n-3 fatty acids; non-small cell lung carcinoma; n-3 fatty acid; Cancerology; Bronchus disease; Advanced stage; Supplementation; Platinum II Complexes; Human; Lung disease; Respiratory disease; Treatment efficiency; Polyunsaturated fatty acid; Response rate; Malignant tumor; Fish oil; Survival; First line treatment; Carboplatin; Unsaturated fatty acid; Cancer
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.25933

BACKGROUND:
Palliative chemotherapy is aimed at increasing survival and palliating symptoms. However, the response rate to first‐line chemotherapy in patients with nonsmall cell lung cancer (NSCLC) is less than 30%. Experimental studies have shown that supplementation with fish oil (FO) can increase chemotherapy efficacy without negatively affecting nontarget tissue. This study evaluated whether the combination of FO and chemotherapy (carboplatin with vinorelbine or gemcitabine) provided a benefit over standard of care (SOC) on response rate and clinical benefit from chemotherapy in patients with advanced NSCLC.
METHODS:
Forty‐six patients completed the study, n = 31 in the SOC group and n = 15 in the FO group (2.5 g EPA + DHA/day). Response to chemotherapy was determined by clinical examination and imaging. Response rate was defined as the sum of complete response plus partial response, and clinical benefit was defined as the sum of complete response, partial response, and stable disease divided by the number of patients. Toxicities were graded by a nurse before each chemotherapy cycle. Survival was calculated 1 year after study enrollment.
RESULTS:
Patients in the FO group had an increased response rate and greater clinical benefit compared with the SOC group (60.0% vs 25.8%, P = .008; 80.0% vs 41.9%, P = .02, respectively). The incidence of dose‐limiting toxicity did not differ between groups (P = .46). One‐year survival tended to be greater in the FO group (60.0% vs 38.7%; P = .15).
CONCLUSIONS:
Compared with SOC, supplementation with FO results in increased chemotherapy efficacy without affecting the toxicity profile and may contribute to increased survival. Cancer 2011;. © 2011 American Cancer Society.
Compared with standard of care, supplementation with fish oil resulted in a 2‐fold increase in chemotherapy efficacy and a trend toward increased survival in patients with advanced lung cancer.