The Effect of Fish Oils on Human Hepatic Colorectal Metastases
Condition: Colorectal Liver Metastases
MeSH terms: Neoplasm Metastasis
Study type: Interventional
Phase: Phase 2

Summary: 
      The purpose of this study is to determine whether fish oils - a known source of omega-3 given
      intravenously (via a 'drip') will help cure secondary deposits in the liver from bowel
      cancer.
    

Detailed description: 
      Fish oils have many proven benefits for a wide range of clinical arenas such as ischaemic
      heart disease, rheumatoid arthritis and inflammatory bowel disease.

      Recent research has described the beneficial effects of intravenous fish oils for surgical
      patients, such as reduced hospital stay, reduced re-operation rate and reduced requirements
      for intravenous antibiotics. These are in part due to the anti-inflammatory effects of fish
      oils.

      There is evidence that fish oils are also effective against cancer, large population studies
      indicate that diets rich in omega-3 are associated with a lower incidence of cancer, and in
      vitro and animal studies demonstrate anti-tumour effects of fish oils

        1. Fish oils inhibit the growth of different human cancer cell lines

        2. They act specifically on tumour cells only and do not impair the function of normal
           cells

        3. EPA and DHA inhibit the growth of human cancer cell lines and enhance apoptosis.

        4. Fish oil induces apoptosis in human colorectal cancer cell lines in-vitro after 48hrs
           incubation

        5. Fish oil has been shown to inhibit the proliferation activities, inhibit the invasive
           activities and increase the apoptosis of human pancreatic carcinoma cell lines in-vitro
           after only 48hrs of exposure

        6. Fish oil has been shown to enhance colorectal adenocarcinoma cell lines sensitivity to
           radiotherapy

        7. Fish oil has also been shown to reduce the incidence of liver metastases in
           experimentally induced ductal pancreatic cancer in rats after 30 weeks of oral treatment
           with an omega-3 supplemented diet.

        8. Lung cancer xenografts in animals fed with fish oil showed significantly increased
           tumour regression in response to doxorubicin compared to those fed with omega-3.

      This study aims to assess the effect of omega-3 FA upon hepatic colorectal metastases in a
      pilot study. 20 patients will be selected for this pilot study with potentially resectable
      hepatic colorectal adenocarcinoma metastases. 10 patients will receive total parenteral
      nutrition (TPN) without fish oils (controls), 10 will receive fish oil containing lipid
      emulsion in their TPN.

      Changes in tumour angiogenesis (increased angiogenesis is associated with a poorer prognosis
      in hepatic colorectal metastases) will be investigated using digital contrast enhanced MRI
      scanning, and markers of angiogenesis will be investigated in blood and resected tumour
      samples from the patients.

      It is a randomised controlled double blind trial.
    

Intervention name(s): Lipidem- fish oil emulsion BBraun UK; Digital Contrast MRI scan
Intervention type(s): Dietary Supplement; Procedure
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Treatment
Keywords: Hepatic; colorectal; metastases; TPN; Fish oil