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Randomized Controlled Trial
. 2019 Nov;8(16):6923-6932.
doi: 10.1002/cam4.2517. Epub 2019 Sep 30.

Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy

Emanuele Cereda  1 , Annalisa Turri  1 , Catherine Klersy  2 , Silvia Cappello  1 , Alessandra Ferrari  3 , Andrea Riccardo Filippi  4 , Silvia Brugnatelli  3 , Marilisa Caraccia  1 , Silvia Chiellino  3 , Valeria Borioli  1 , Teresa Monaco  3 , Giulia Maria Stella  5 , Luca Arcaini  6   7 , Marco Benazzo  8   9 , Giuseppina Grugnetti  10 , Paolo Pedrazzoli  3   11 , Riccardo Caccialanza  1
Affiliations
Randomized Controlled Trial

Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy

Emanuele Cereda et al. Cancer Med. 2019 Nov.

Abstract

In recent years, whey proteins (WP) have attracted increasing attention in health and disease for their bioactive functions. The aim of this study was to evaluate the benefit of WP isolate (WPI) supplementation in addition to nutritional counseling in malnourished advanced cancer patients undergoing chemotherapy (CT). In a single-center, randomized, pragmatic, and parallel-group controlled trial (ClinicalTrials.gov: NCT02065726), 166 malnourished advanced cancer patients with mixed tumor entities candidate to or undergoing CT were randomly assigned to receive nutritional counseling with (N = 82) or without (N = 84) WPI supplementation (20 g/d) for 3 months. The primary endpoint was the change in phase angle (PhA). Secondary endpoints included changes in standardized PhA (SPA), fat-free mass index (FFMI), body weight, muscle strength, and CT toxicity (CTCAE 4.0 events). In patients with the primary endpoint assessed (modified intention-to-treat population), counseling plus WPI (N = 66) resulted in improved PhA compared to nutritional counseling alone (N = 69): mean difference, 0.48° (95% CI, 0.05 to 0.90) (P = .027). WPI supplementation also resulted in improved SPA (P = .021), FFMI (P = .041), body weight (P = .023), muscle strength (P < .001), and in a reduced risk of CT toxicity (risk difference, -9.8% [95% CI, -16.9 to -2.6]; P = .009), particularly of severe (grade ≥ 3) events (risk difference, -30.4% [95% CI, -44.4 to -16.5]; P = .001). In malnourished advanced cancer patients undergoing CT, receiving nutritional counseling, a 3-month supplementation with WPI resulted in improved body composition, muscle strength, body weight, and reduced CT toxicity. Further trials, aimed at verifying the efficacy of this nutritional intervention on mid- and long-term primary clinical endpoints in newly diagnosed specific cancer types, are warranted.

Keywords: cancer; malnutrition; nutritional counseling; whey proteins.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Study flow diagram
See this image and copyright information in PMC

References

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