Cancer-Associated Muscle Atrophy and Weakness: An Investigation of Etiology

Study Overview
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Brief Summary
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This study is designed to gain a better understanding of the mechanisms leading to muscle wasting and metabolic abnormalities in skeletal muscle of cancer patients.

Official Title
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Cancer-Associated Muscle Atrophy and Weakness: An Investigation of Etiology

Conditions
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Metastatic Cancer, Cachexia; Cancer

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 35-80 years Diagnosis of metastatic cancer with cachexia (≥5% drop in body mass in less than 12 months), metastatic cancer without cachexia (<5% drop in body mass in 12 months) or no history of cancer but similar in age and sex as other groups. Exclusion Criteria: Current use of vitamin D analogs Fasting plasma glucose ≥126 mg/dL Renal failure (serum creatinine > 1.5mg/dl) Chronic active liver disease (Bilirubin > 17mmol/L, AST>144IU/L, or ALT>165IU/L) Contraindications to MRI (e.g., pacemaker, ferrous materials within body). Active coronary artery disease or history of unstable macrovascular disease (unstable angina, myocardial infarction, stroke, and revascularization of coronary, peripheral or carotid artery within 3 months of recruitment) Renal insufficiency/failure (serum creatinine > 1.5mg/dl) Oral warfarin group medications or history of blood clotting disorders. People who have taken Bevacizumab Platelet count <100,000 per uL Pregnancy or breastfeeding Alcohol consumption greater than 2 glasses/day or other substance abuse Untreated or uncontrolled thyroid disorders Debilitating chronic disease (at the discretion of the investigators) Previous injury/trauma/surgery to the region being measured without full recovery Pain in the area to be assessed Any medical condition affecting the ability to execute a maximal muscle contraction The presence of infections, highly communicable diseases (AIDS, active tuberculosis, veneral disease, hepatitis) or metastatic bone disease that may interfere with safely executing maximal effort. Significant neurological or musculoskeletal disorders or disease that may interfere with safely executing maximal contraction Any congenital, developmental, or other bone disease or previous surgeries that may interfere with successful testing

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cancer with cachexia<br>Men and women (ages 35-80 years) with cancer cachexia (≥5% drop in body mass in less than 12 months) | |
| Cancer without cachexia<br>Men and women (ages 35-80 years) with cancer but without cachexia of similar age and sex as the group with cachexia | |
| No cancer<br>Men and women (ages 35-80 years) without cancer, but similar age and sex as groups with cancer. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Skeletal muscle oxidative capacity | Muscle oxidative capacity will be measured by magnetic resonance spectroscopy | Approximately within a month of recruitment | 
| Skeletal muscle protein synthesis | Muscle protein synthesis will be measured in the postabsorptive state from the rate of incorporation of isotopically labeled amino acids given intravenously. | Approximately within a month of recruitment |