Does megestrol acetate down-regulate interleukin-6 in patients with cancer-associated anorexia and weight loss? A North Central Cancer Treatment Group investigation
Does megestrol acetate down-regulate interleukin-6 in patients with cancer-associated anorexia and weight loss? A North Central Cancer Treatment Group investigation
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DOI：
10.1007/s00520-001-0310-7
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发表时间：
2002-01-01
影响因子：
3.1
通讯作者：
Loprinzi, CL
中科院分区：
文献类型：
--
作者：
Jatoi, A;Yamashita, J;Loprinzi, CL
甲地孕酮改善一些晚期癌症患者的食欲和体重减轻。此外，初步研究表明，孕激素下调白介素6(IL-6)的水平，白介素6是一种炎性细胞因子，广泛与癌症相关的厌食症和体重减轻有关。本研究检测了甲地孕酮对IL-6的影响，试图证实这些早期的初步研究。作为一项大型多机构试验的翻译部分，这项调查检查了85名晚期癌症患者和体重减轻的患者。患者被随机分配到接受甲地孕酮液体混悬液800毫克/天+安慰剂片，或口服屈诺比诺2.5毫克，每天2次。+液体安慰剂，或两者兼而有之。其他测试包括连续医生报告的体重和患者报告的食欲和全球生活质量。经单因素方差分析，患者治疗后1个月血清IL-6的变化与甲地孕酮、屈诺比诺及联合用药的差异无统计学意义：平均标准差分别为-1.52+/-4.7pg/ml、-0.62+/-3.5pg/ml、-0.2+/-3.1pg/ml(P=0.40)。在注意到食欲变化超过1个月的患者中，我们没有观察到IL-6的显著变化。最后，血清IL-6的变化与体重变化或全球生活质量无关。我们的研究没有提供证据表明醋酸甲地孕酮下调癌症相关厌食症和体重减轻患者的IL-6水平。
Megestrol acetate improves appetite and abrogates weight loss in some patients with advanced cancer. Moreover, preliminary studies suggest that progestational agents down-regulate interleukin-6 (IL-6), an inflammatory cytokine widely implicated in cancer-associated anorexia and weight loss. The present investigation examined the effects of megestrol acetate on IL-6 in an attempt to confirm these earlier, preliminary studies. The translational component of a large multi-institutional trial, this investigation examined 85 patients with advanced cancer and weight loss. Patients had been randomly assigned to receive megestrol acetate liquid suspension 800 mg/day + placebo tablets, or oral dronabinol tablets 2.5 mg b.i.d. + liquid placebo, or both agents. Other testing included serial physician-reported weight and patient-reported appetite and global quality of life. We found no significant differences in 1-month changes in serum IL-6 according to whether patients had been treated with megestrol acetate, dronabinol, or the combination: the mean differences standard deviation were -1.52 +/-4.7 pg/ml, -0.62 +/-3.5 pg/ml, and -0.2 +/-3.1 pg/ml, respectively (P=0.40, by one-way ANOVA). Among the patients who noted alterations in their appetite over 1 month, we observed no significant changes in IL-6. Finally, changes in serum IL-6 were not associated with shifts in weight or global quality of life. Our investigation provides no evidence that megestrol acetate down-regulates IL-6 in patients with cancer-associated anorexia and weight loss.