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Omega-3 and Vitamin D Supplementation in Breast Cancer Women

Early Phase 1
Completed
Conditions
Breast Cancer Female
Interventions
Combination Product: Combined Omega-3 and Vitamin D Supplementation
Dietary Supplement: Omega-3 FA
Dietary Supplement: Vitamin D
Registration Number
NCT05331807
Lead Sponsor
Universiti Sains Malaysia
Brief Summary

Breast cancer (BC) is the most common malignant disease, which is fifth leading cause of cancer mortality worldwide. Poor nutritional status is one of the common physical symptoms found among cancer patients, in which it is caused by both cancer disease state and its oncology treatment regimens used. Cancer patients develop a tumor-associated malnutrition characterized by an insufficient supply of macro- and micronutrients and systemic chemotherapy treatment that could significantly affecting the nutritional status of these patients by its side effects associated with chemotherapy that may lead to many medical complications that often requires hospitalization and death. An adequate nutritional intervention can have a beneficial impact on the disease condition and also the progress of the disease, as an integral part of adjuvant therapy on cancer care. Numerous studies had shown that the use of EPA and DHA are safe (absence of cardiotoxic effects) and effective in reducing the common chemotherapy-related side effects, such as bone density loss, peripheral neuropathy and weight gain. The question remains arises to whether administration of both vitamin D and omega-3 fatty acids supplementations could be used as important nutritional strategy during the active oncology treatment in breast cancer patients. In Palestine, nutritional intervention strategies are poorly evaluated in the oncology setting especially among patients undergoing chemotherapy. Suitable and proper nutritional interventions among breast cancer patients during active oncology treatments could help to improve nutritional status, decrease mortality and improve quality of life among these subjects. Hence, the present study is formulated to assess the effect of combined omega-3 fatty acid and vitamin D supplementation on the nutritional status, quality of life and blood inflammatory markers among breast cancer women undergoing chemotherapy treatment in the Gaza Strip, Palestine.

Detailed Description

An adequate nutritional intervention can have a beneficial impacts on the disease condition and also the progress of the disease, as an integral part of adjuvant therapy on cancer care. Numerous clinical and epidemiological studies had found that vitamin D deficiency is common nutritional disorder in BC patients and that significantly associated with a negative prognostic factor, in which some have reported a positive effect of combining vitamin D or its analogues as an adjuvant therapy, together with a variety of chemotherapeutic factors used during oncology treatments. Moreover, combination of vitamin D and omega-3 fatty acids may provide a new complementary treatment by decreasing inflammatory biomarkers and resistance to cancer treatment in patients with BC. The question remains whether vitamin D and omega-3 fatty acids co-supplementation would actually be useful after diagnosis of BC. So, the aim of this study is to investigate the effects of vitamin D and omega-3 fatty acids co-supplementation on inflammatory biomarkers, and nutritional status in patients with BC.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
88
Inclusion Criteria
  • Females who have been newly diagnosed with the breast cancer of stage I, II and III
  • Patients with following clinical diagnosis of breast cancer such as lymph node positive +ve, hormonal receptor negative -ve and human epidermal growth factor receptor 2 (HER2) negative -ve
  • Patient will receive her first chemotherapy treatment with Adriamycin + Cytoxan (AC) for a total of four cycle (each cycle will be carried-out every 3 weeks (21 days)
Exclusion Criteria
  • Participants who had already undertaken her chemotherapy previously, and/or other oncology treatments such as hormonal or radiation oncology therapy
  • Patients with recurrent breast cancer, patients with other chronic disease conditions such as renal disease and under dialysis, HIV, malabsorption disorder diseases, autoimmune diseases, diabetes, hypertension, hepatic, parathyroid, and gastrointestinal disorders.
  • Patients who have reported any allergy condition to fish and/or fish products
  • Pregnant women

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group (C)Combined Omega-3 and Vitamin D SupplementationParticipants will be received both omega-3 fatty acids capsules and vitamin D3 capsule. (one capsule of D3 50,000 IU weekly + two omega-3 fatty acids capsules daily (each capsule contains 300 mg of omega-3 fatty acids)
Group (A)Omega-3 FAParticipants will be received daily omega-3 fatty acid (two capsules of 1000mg fish oil daily). Each soft gel capsule contains 300 mg of omega-3 fatty acids in the bioactive triglyceride (TG) and 180mg EPA and 120 mg DHA. (Omega3 complex, Jamieson Laboratories, Canada)
Group (B)Vitamin DParticipants will be received only vitamin D (one capsule of 50,000IU weekly). Each film coated tablet of vitamin D contains 50,000 IU Vitamin D3 (Cholecalciferol). (J-Dee, Jerusalem Pharmaceutical Company, West bank, Palestine).
Primary Outcome Measures
NameTimeMethod
Change of Blood inflammatory markers of blood TNF-α levelsChange from baseline TNF-α levels in pg/mL at 2 months

Blood concentration of TNF-α levels will be measured in unit pg/mL.

Change of Nutritional Status Assessed by body weight levelsChange from baseline weight in kg at 2 months

Body weight will be measured in kilograms

Change of Muscle Mass StatusChange from Baseline calf circumference in cm at 2 months

Muscle mass status will be assessed by calf circumference levels in cm. Higher values of calf circumference is indicative of greater lean mass.

Change of Blood inflammatory markers of blood CRP levelsChange from baseline CRP levels in nmol/L at 2 months

Blood concentration of CRP levels will be measured in nmol/L

Change of Nutritional status, as assessed by Body Mass IndexChange from Baseline BMI at 2 months

Body weight in kilograms and height in meters will be combined to report BMI in kg/m\^2

Change of body weightChange from Baseline Weight in kg at 2 months

Body weight will be measured in kilograms

Change of Total Scale and Single-item measures Scores derived from the Quality of life questionnaire (QLQ C-30) assessmentChange from Baseline total scales and single-item measures scores (0 to 100 scores) at 2 months

The EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) assessment of 30 questions to measure cancer patients' physical, psychological and social functions. All of the scales and single-item measures range in score from 0 to 100. Higher score for the functioning scales and global health status denote a better level of functioning (i.e. a better state of the patient), while higher scores on the symptom and single-item scales indicate a higher level of symptoms (i.e. a worse state of the patient).

Change of Nutritional Status Condition, as assessed by the Patient-Generated Subjective Global Assessment PG-SGAChange from Baseline Nutritional Status Condition in category of well-nourished, moderately malnourished or severely malnourished at 2 months

The PG-SGA will be based four components such as questions related to body weight status (scored 0-5), food intake (score 0-4); symptoms affecting oral food intake (scored 0-23), and lastly questions on daily activities and function, in which the degree of malnutrition of patients will be classified as (A) well-nourished; (B) moderately malnourished; or (C) severely malnourished.

Secondary Outcome Measures
NameTimeMethod
Change of Dietary Protein IntakesChange from Baseline dietary Protein intakes in grams at 2 months

Habitual dietary protein intakes will be assessed by mean protein intakes in grams

Lifestyle physical activity statusChange from Baseline Physical Activity Status (inactive, minimally active or active physical activity status) at 2 months

A short form of the international physical activity questionnaire (IPAQ) will be used to assess the physical activity levels of the study participants, in which three different category groups of inactive, minimally active and active will be categorised.

Change of Dietary Energy IntakesChange from Baseline dietary energy intakes in kcal at 2 months

Habitual dietary nutrients intake will be assessed by mean energy intakes in kcal

Change of Dietary Vitamin D intakesChange from Baseline Dietary Vitamin D Intakes in microgram at 2 months

Habitual dietary nutrients intake will be assessed by mean vitamin D intakes in micrograms

Change of Dietary Fat IntakesChange from Baseline dietary fat intakes in grams at 2 months

Habitual dietary nutrients intake will be assessed by mean fat intakes in grams

Trial Locations

Locations (1)

Turkish-Palestinian Friendship Hospital

🇵🇸

Al-Zahra, Gaza Strip, Palestinian Territory, occupied

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