Evidence map›Paper›PMID 20156909›Full record

Trial reportThe oncologist2010

Randomized phase III clinical trial of five different arms of treatment in 332 patients with cancer cachexia.

Giovanni Mantovani, Antonio Macciò, Clelia Madeddu, Roberto Serpe, Elena Massa, Mariele Dessì, Filomena Panzone, Paolo Contu

Registry-linked trialOpen access · bronzeAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The oncologist, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05198856 (A Single-arm, Open, Prospective, Multi-center Study on Thalidomide Combined With First-line Chemotherapy and Monotherapy for Maintenance Treatment of Liver Metastases From Her2-negative Advanced Gastric Cancer), which is not on this map. Cited by 92 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
92citing papers in PubMed, 16 pooled it
10.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05198856 phase1 / phase2unknown statusnot on this mapstarted 2022, after this paper: background citation

A Single-arm, Open, Prospective, Multi-center Study on Thalidomide Combined With First-line Chemotherapy and Monotherapy for Maintenance Treatment of Liver Metastases From Her2-negative Advanced Gastric Cancer

TypeinterventionalSponsorQilu Hospital of Shandong UniversityRan2022 to 2024Enrolled106ConditionsGastric Cancer Metastatic to LiverArmsThalidomide Combined With Chemotherapy and Monotherapy
3 · Its place in the literature

Who cites it

92 citing papers in PubMed, 16 syntheses or guidelines pooled it, 224 citations in OpenAlex.

  1. Comparison of EPA and DHA&EPA on body weight, BMI, and lean body mass in cancer patients: a network meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Pooled it
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  3. Multimodal interventions for cachexia management.The Cochrane database of systematic reviews · 2025
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  9. Guideline
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  14. Systematic review of the multidimensional fatigue symptom inventory-short form.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2015
    Pooled it
  15. Megestrol acetate for treatment of anorexia-cachexia syndrome.The Cochrane database of systematic reviews · 2013
    Pooled it
  16. Thalidomide for managing cancer cachexia.The Cochrane database of systematic reviews · 2012
    Pooled it
  17. Trial
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32 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Giovanni MantovaniDepartment of Medical Oncology,University of Cagliari, Cagliari, Italy. mantovan@medicina.unica.it
Antonio Macciò
Clelia Madeddu
Roberto Serpe
Elena Massa
Mariele Dessì
Filomena Panzone
Paolo Contu
University of Cagliari · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA phase III, randomized study was carried out to establish the most effective and safest treatment to improve the primary endpoints of cancer cachexia-lean body mass (LBM), resting energy expenditure (REE), and fatigue-and relevant secondary endpoints: appetite, quality of life, grip strength, Glasgow Prognostic Score (GPS) and proinflammatory cytokines. PATIENTS AND

methodsThree hundred thirty-two assessable patients with cancer-related anorexia/cachexia syndrome were randomly assigned to one of five treatment arms: arm 1, medroxyprogesterone (500 mg/day) or megestrol acetate (320 mg/day); arm 2, oral supplementation with eicosapentaenoic acid; arm 3, L-carnitine (4 g/day); arm 4, thalidomide (200 mg/day); and arm 5, a combination of the above. Treatment duration was 4 months.

resultsAnalysis of variance showed a significant difference between treatment arms. A post hoc analysis showed the superiority of arm 5 over the others for all primary endpoints. An analysis of changes from baseline showed that LBM (by dual-energy X-ray absorptiometry and by L3 computed tomography) significantly increased in arm 5. REE decreased significantly and fatigue improved significantly in arm 5. Appetite increased significantly in arm 5; interleukin (IL)-6 decreased significantly in arm 5 and arm 4; GPS and Eastern Cooperative Oncology Group performance status (ECOG PS) score decreased significantly in arm 5, arm 4, and arm 3. Toxicity was quite negligible, and was comparable between arms.

conclusionThe most effective treatment in terms of all three primary efficacy endpoints and the secondary endpoints appetite, IL-6, GPS, and ECOG PS score was the combination regimen that included all selected agents.

Indexed as

Appetite StimulantsCachexiaCarnitineEicosapentaenoic AcidFemaleHumansInterleukin-6MaleMedroxyprogesteroneMegestrol AcetateMiddle AgedNeoplasmsThalidomideVitamin B ComplexAppetite StimulantsCarnitineEicosapentaenoic AcidInterleukin-6MedroxyprogesteroneMegestrol AcetateThalidomideVitamin B Complex

Identifiers

PMID20156909
PMCPMC3227938
OpenAlexW2126536849

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.