Evidence map›Paper›PMID 37671529›Full record

SynthesisJournal of cachexia, sarcopenia and muscle2023

Physical function endpoints in cancer cachexia clinical trials: Systematic Review 1 of the cachexia endpoints series.

James McDonald, Judith Sayers, Stefan D Anker, Jann Arends, Trude Rakel Balstad, Vickie Baracos, Leo Brown, Asta Bye, Olav Dajani, Ross Dolan and 20 more

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of cachexia, sarcopenia and muscle, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 7 pooled it
8.2field-weighted citation impact, top 2% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 7 syntheses or guidelines pooled it, 47 citations in OpenAlex.

  1. Pooled it
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  3. Multimodal interventions for cachexia management.The Cochrane database of systematic reviews · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors at 12 institutions in 8 countries.

James McDonaldEdinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.
Judith SayersEdinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.
Stefan D AnkerDepartment of Cardiology (CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT), and German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany.
Jann ArendsDepartment of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
Trude Rakel BalstadDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
Vickie BaracosDivision of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, AB, Canada.
Leo BrownClinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.
Asta ByeRegional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital/European Palliative Care Research Centre (PRC), and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Olav DajaniRegional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital/European Palliative Care Research Centre (PRC), and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Ross DolanAcademic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.
Marie T FallonEdinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.
Eilidh FraserEdinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.
Christine GrielDepartment of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
Aleksandra GrzybEdinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.
Marianne HjermstadRegional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital/European Palliative Care Research Centre (PRC), and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Mariam Jamal-HanjaniCancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK.
Gunnhild JakobsenDepartment of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
Stein KaasaRegional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital/European Palliative Care Research Centre (PRC), and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Donald McMillanAcademic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.
Matthew MaddocksCicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.
Iain PhilipsEdinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.
Inger O OttestadDepartment of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway and The Clinical Nutrition Outpatient Clinic, Section of Clinical Nutrition, Department of Clinical Service, Division of Cancer Medicine, Harvard Medical SchoolOslo University Hospital, Norway.
Kieran F ReidLaboratory of Exercise Physiology and Physical Performance, Boston Claude D. Pepper Older Americans Independence Center for Function Promoting Therapies, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Mariana S SousaImproving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), University of Technology Sydney, Sydney, NSW, Australia.
Melanie R SimpsonDepartment of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
Ola Magne VagnildhaugCancer Clinic, St Olavs Hospital - Trondheim University Hospital, Trondheim, Norway.
Richard J E SkipworthClinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.
Tora S SolheimCancer Clinic, St Olavs Hospital - Trondheim University Hospital, Trondheim, Norway.
Barry J A LairdEdinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-2807-6192
Cancer Cachexia Endpoints Working Group
Edinburgh Cancer Research · GBNorwegian University of Science and Technology · NOOslo University Hospital · NOEdinburgh Royal Infirmary · GBGlasgow Royal Infirmary · GBUniversity of Freiburg · DEBrigham and Women's Hospital · USKing's College London · GBRoyal London Hospital · GBUniversity of Alberta · CAUniversity of Technology Sydney · AUWroclaw Medical University · PL

Funding

Cancer Research UK 17786Cancer Research UK 21999Cancer Research UK 30025
6 · The paper itself

Abstract

In cancer cachexia trials, measures of physical function are commonly used as endpoints. For drug trials to obtain regulatory approval, efficacy in physical function endpoints may be needed alongside other measures. However, it is not clear which physical function endpoints should be used. The aim of this systematic review was to assess the frequency and diversity of physical function endpoints in cancer cachexia trials. Following a comprehensive electronic literature search of MEDLINE, Embase and Cochrane (1990-2021), records were retrieved. Eligible trials met the following criteria: adults (≥18 years), controlled design, more than 40 participants, use of a cachexia intervention for more than 14 days and use of a physical function endpoint. Physical function measures were classified as an objective measure (hand grip strength [HGS], stair climb power [SCP], timed up and go [TUG] test, 6-min walking test [6MWT] and short physical performance battery [SPPB]), clinician assessment of function (Karnofsky Performance Status [KPS] or Eastern Cooperative Oncology Group-Performance Status [ECOG-PS]) or patient-reported outcomes (physical function subscale of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaires [EORTC QLQ-C30 or C15]). Data extraction was performed using Covidence and followed PRISMA guidance (PROSPERO registration: CRD42022276710). A total of 5975 potential studies were examined and 71 were eligible. Pharmacological interventions were assessed in 38 trials (54%). Of these, 11 (29%, n = 1184) examined megestrol and 5 (13%, n = 1928) examined anamorelin; nutritional interventions were assessed in 21 trials (30%); and exercise-based interventions were assessed in 6 trials (8%). The remaining six trials (8%) assessed multimodal interventions. Among the objective measures of physical function (assessed as primary or secondary endpoints), HGS was most commonly examined (33 trials, n = 5081) and demonstrated a statistically significant finding in 12 (36%) trials (n = 2091). The 6MWT was assessed in 12 trials (n = 1074) and was statistically significant in 4 (33%) trials (n = 403), whereas SCP, TUG and SPPB were each assessed in 3 trials. KPS was more commonly assessed than the newer ECOG-PS (16 vs. 9 trials), and patient-reported EORTC QLQ-C30 physical function was reported in 25 trials. HGS is the most commonly used physical function endpoint in cancer cachexia clinical trials. However, heterogeneity in study design, populations, intervention and endpoint selection make it difficult to comment on the optimal endpoint and how to measure this. We offer several recommendations/considerations to improve the design of future clinical trials in cancer cachexia.

Indexed as

CachexiaNeoplasmsHand StrengthHumansQuality of LifeResearch Designcachexiacancerendpointsphysical functiontrials

Identifiers

PMID37671529
PMCPMC10570071
OpenAlexW4386466547

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.