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A trial looking at different ways of preventing weight and muscle loss for people having treatment for advanced pancreatic cancer (MENAC)

Research title: A randomised trial of a multimodal intervention (exercise, nutrition and anti-inflammatory medication) plus standard care, versus standard care alone to prevent or reduce cachexia in people with advanced pancreatic cancer undergoing anti-cancer treatment.

Why is this trial being carried out?

Cancer cachexia is a condition where your body loses fat and muscle. Cachexia causes weight loss, loss of appetite and extreme tiredness (fatigue). It is common in people with pancreatic cancer. Cachexia is different to losing weight, and trying to eat more may not help the symptoms of cachexia. 

The MENAC trial is a phase 3 trial for people who are due to start treatment, such as chemotherapy or radiotherapy, for advanced pancreatic cancer. Advanced pancreatic cancer is cancer that has spread from the pancreas to other parts of the body, and can’t be removed with surgery.

The MENAC trial wants to find ways to prevent cachexia. The trial will compare taking standard nutritional supplements to using a combination of trial treatments, which are:

  • a nutritional supplement drink and advice about your diet
  • an anti-inflammatory medicine called ibuprofen
  • and an exercise programme that you do at home.

Who is the trial suitable for?

The MENAC trial may be suitable for you if you:

  • have a type of advanced pancreatic cancer called pancreatic ductal adenocarcinoma
  • are due to start treatment, such as chemotherapy or radiotherapy
  • are able to do light exercise and take nutritional supplements
  • are not allergic to the anti-inflammatory drug ibuprofen – your medical team can discuss this with you.

The MENAC trial may not suitable for you if you:

  • have a pancreatic neuroendocrine tumour (PancNET)
  • have had a test that shows that your kidneys are not working normally
  • are receiving nutrition into your bloodstream (parenteral) – your medical team can discuss this with you
  • have been taking medicines to increase your appetite 30 days before the trial starts
  • have been taking steroids up to three months before the trial starts
  • are taking aspirin or non-steroidal anti-inflammatory medicines (NSAID’s)
  • are using blood-thinning treatment (anti-coagulants), such as warfarin or heparin.

There may be other reasons for not being able to take part in a trial. It is important to speak to your doctor about whether this trial might be suitable for you.

What does the trial involve?

This is a randomised trial, which means that you will be randomly selected by a computer to be in one of two groups.

  • People in group one will have the combination of the trial treatments above for 12 weeks.
  • People in group two will have standard nutritional supplements for six weeks. After this they will have the combination of trial treatments for six weeks.

The exercise programme that you do at home will involve doing some light, simple exercise; this might include going for a walk, or doing some strengthening exercises for your upper body and legs. To measure your activity, you will be asked to wear a small electronic device on your leg during the first week of the trial and about six weeks into the trial.

The diet advice will help to make sure you are eating enough of the right foods. You will also have a nutritional supplement drink twice a day, which is high in calories and nutrients.

You will have blood tests before and during the trial. You will also have a CT scan before the trial and about six weeks into the trial. These tests will measure any differences between the treatments groups, to see if the combination of trial treatments helps reduce muscle and fat loss.

Recruitment start date: April 2015

Recruitment end date: December 2021

  • The MENAC trial is being carried out at:

    • Edinburgh Cancer Centre, Scotland
    • Beatson West of Scotland Cancer Centre, Scotland
    • Queen Margaret Hospital, Scotland
    • Guy's and St Thomas Hospital, London
    • University Hospital Llandough, Cardiff

    Trial lead

    Marie Fallon, University of Edinburgh, Scotland

    Contact information

    You can contact the trial centre’s using this email address: menac@soton.ac.uk

  • How to join a trial

    Please speak to your consultant about whether this trial is suitable for you.

    If you have any questions about pancreatic cancer you can speak to one of our specialist nurses on freephone 0808 801 0707.

    How to find out more

    Find out more about the MENAC trial.

    For references used to develop this information please email us.