{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T20:24:10Z","timestamp":1760300650013,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:00:00Z","timestamp":1633392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001784","name":"Pancreatic Cancer Action Network","doi-asserted-by":"publisher","award":["20\u201020\u2010GRES"],"award-info":[{"award-number":["20\u201020\u2010GRES"]}],"id":[{"id":"10.13039\/100001784","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Advanced pancreatic ductal adenocarcinoma (PDAC) is characterized by progressive weight loss and nutritional deterioration. This wasting has been linked to poor survival outcomes, alterations in host defenses, decreased functional ability, and diminished health\u2010related quality of life (HRQOL) in pancreatic cancer patients. There are currently no standardized approaches to the management of pancreatic cancer cachexia. This study explores the feasibility and efficacy of enteral tube feeding of a peptide\u2010based formula to improve weight stability and patient\u2010reported outcomes (PROs) in advanced PDAC patients with cachexia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010institution, single\u2010arm prospective trial conducted between April 2015 and March 2019. Eligible patients were adults (&gt;18\u00a0years) diagnosed with advanced or locally advanced PDAC and cachexia, defined as greater than 5% unexplained weight loss within 6\u00a0months from screening. The study intervention included three 28\u00a0day cycles of a semi\u2010elemental peptide\u2010based formula, administered through a jejunal or gastrojejunal feeding tube. The primary outcome was weight stability at 3\u00a0months (Cycle 3), defined as weight change less than 0.1\u00a0kg\/baseline BMI unit from baseline. Secondary outcomes included changes in lean body mass, appendicular lean mass, bone mineral density, fat mass, and percent body fat, as measured with a DEXA scan, HRQOL (EORTC QLQC30) and NIH PROMIS PROs assessed at each cycle. Daily activity (steps, distance, active minutes, heart rate, and sleep) were remotely monitored using a wearable activity monitor (Fitbit) over the 3\u00a0month study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010six patients were screened for eligibility, 31 patients consented onto study and underwent jejunal tube placement, and 16 patients completed treatment: mean age 67\u00a0years (SD 9.3), 43.8% male. Among evaluable patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a016), weight stability was achieved in 10 patients (62.5%), thus completing the trial early. Increases in lean body mass (1273.1, SD: 4078, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) and appendicular lean mass (0.45, SD: 0.6, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02) were observed. Statistically significant improvements at Cycle 3 from baseline were also observed for QLQC30 role function [mean difference (MD): 20.1, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03], appetite (MD: 27.4, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02), and global health scores (MD: 13.3, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.05) as well as for NIH PROMIS <jats:italic>t<\/jats:italic>\u2010scores for depression (MD: \u221210.4, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.006) and pain interference (MD: \u22127.5, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.05). Objectively monitored (Fitbit) activity levels increased, although statistical significance was not reached.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that enteral nutrition support may improve weight stability, lean body mass, appendicular lean mass and PROs in PDAC patients with cachexia who completed treatment, representing a subsample of the study population. The feasibility and role of enteral feeding in routine care remain unclear, and larger and randomized controlled trials are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12799","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T14:57:05Z","timestamp":1633618625000},"page":"1959-1968","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Feasibility and efficacy of enteral tube feeding on weight stability, lean body mass, and patient\u2010reported outcomes in pancreatic cancer cachexia"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7142-1230","authenticated-orcid":false,"given":"Gillian","family":"Gresham","sequence":"first","affiliation":[{"name":"Department of Medicine Samuel Oschin Comprehensive Cancer Institute, Cedars\u2010Sinai Medical Center  Los Angeles CA 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