Cancer Cachexia, Colorectal Cancer
Conditions
Keywords
colorectal cancer, cachexia, skeletal muscle, skeletal muscle fibers, capillarization
Brief summary
Until now, cancer is still associated with high morbidity and mortality, and is therefore a big issue for the public health. Colorectal cancer is the second leading cause of cancer death in developed countries. In advanced colorectal cancer, 60% of these patients develop cachexia. The presence of cachexia plays an important role in the high mortality rate of cancer. Cachexia is characterized by involuntary weight loss with loss of skeletal muscle with or without loss of fat mass. The aim of this study is to determine the feasibility of taking muscle biopsies of cachectic colorectal cancer patients. Skeletal muscle characteristics will be compared between biopsies of the m. erector spinae and the m. vastus lateralis from cachectic colorectal cancer patients, non-cachectic colorectal cancer patients and healthy controls. 10 cachectic, 25 non-cachectic, and 25 healthy controls will be recruited for this study. It is an observational study, so measurements will be taken at one time point. Interventions/measurements: * muscle biopsies * blood samples * 3D freehand ultrasound * Short physical performance battery test * handgrip strength * questionnaires (activity pattern, quality of life)
Interventions
PROCEDUREMinimal invasive fine needle muscle biopsies
Fine needle muscle biopsies will be taken from the m. erector spinae and the m. vastus lateralis. Participants are placed in a standardized prone position on the examination table for measurements of the m. erector spinae and in a supine position for measurements of the m. vastus lateralis.
Sponsors
Hasselt University
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Cachectic colorectal cancer patients. Inclusion criteria: * minimum age of 18 years old * unwanted weight loss \> 5% in the last 6 months OR \> 2% unwanted weight loss in combination with a BMI \< 20kg/m2 OR \>2% unwanted weight loss in combination with sarcopenia * Cachexia staging score (CSS): 5-12
Exclusion criteria
* Mental of psychological condition * Insufficient knowledge of the Dutch language * Muscle diseases affecting the spine and lower limbs * Bedridden Non-Cachectic cancer patients. Inclusion criteria: * minimum age of 18 years old * No unwanted weight loss \> 5% in the last 6 months OR \> 2% unwanted weight loss in combination with a BMI \< 20kg/m2 OR \>2% unwanted weight loss in combination with sarcopenia * Cachexia staging score (CSS): 0-2
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Skeletal muscle fiber typing | at enrollment | Immunofluorescence staining of skeletal muscle biopsies to observe different muscle fiber types (myosin heavy chains) |
| skeletal muscle nuclei | at enrollment | Immunofluorescence staining with DAPI |
| Inflammatory parameters | at enrollment | ELISA (bloodsamples), immunofluorescence staining (muscle biopsies) |
| Mitochondrial morphology | at enrollment | mitochondrial fusion and fission (western blot) mitochondrial OXPHOS (western blot) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Handgrip strength | at enrollment | Using the JAMAR to measure the handgripstrength |
| Short Physical Performance Battery (SPPB) test | at enrollment | Including a balance test, sit-to-stand test and four meter walking test |
| 3D freehand ultrasound | at enrollment | measuring the volume of the m. rectus femoris |
| skeletal muscle capillarization | at enrollment | Immunofluorescence staining for capillaries in the skeletel muscle biopsies. |
| Quality of Life questionnaire | at enrollment | SF-36 questionnaire 36-item patient-reported questionnaire that covers eight health domains: physical functioning (10 items), bodily pain (2 items), role limitations due to physical health problems (4 items), role limitations due to personal or emotional problems (4 items), emotional well-being (5 items), social functioning (2 items), energy/fatigue (4 items), and general health perceptions (5 items). Scores for each domain range from 0 to 100, with a higher score defining a more favorable health state. |
| CT-scans | at enrollment | level lumbar 3 To calculate the cross-sectional area of the m. erector spinae. |
| Activity pattern | at enrollment | PASIPD questionnaire |
| VAS score | at enrollment | to descripe the pain at the moment of the biopsy procedure. Score range is 0 to 10. With 0 no pain until 10 the worst pain. |
Countries
Belgium
Contacts
Primary ContactBritt van de Haterd, PhD student
Backup ContactKenneth Verboven, Professor
Outcome results
None listed