Barry James Anderson Laird

• Hadzibegovic, Sara; Hella, Jonathan L.; Porthun, Jan; Lena, Alessia; Krug, Danara & Baluta, Iulia [Show all 22 contributors for this article] (2026). Association of altered body composition with cardiac wasting in cancer with and without cardiotoxic therapy. British Journal of Pharmacology. ISSN 0007-1188. p. 1–18. doi: 10.1111/bph.70639. Full text in Research Archive Show summary

  Background and Purpose In advanced cancer, associations among changes in body composition, cardiac wasting and prior cardiotoxic anticancer therapy have not been investigated. Experimental Approach Using bioelectrical impedance analysis (BIA), body composition was measured in 206 patients with mostly advanced cancer without known cardiovascular disease or infection (stage III/IV: 84%, prior cardiotoxic anticancer therapy: 55%). Left ventricular (LV) mass was assessed by transthoracic echocardiography and grouped by presence of cardiac wasting according to previously established sex‐specific thresholds for LV mass adjusted for height 2 (<61 g/m 2 for women, <57 g/m 2 for men). BIA measurements (indexed to height 2 ) included fat mass index (FMI), fat‐free mass index (FFMI), skeletal muscle mass index (SMMI), visceral fat index (VFI), total body water index (TBWI) and extracellular water index (ECWI). Key Results Patients with cancer and cardiac wasting ( n = 88) were younger (57±15 vs 62±13 years) and more often women (68% vs 29%) compared to those without cardiac wasting ( n = 118). Patients with cardiac wasting had significantly lower FMI (−12%), FFMI (−14%), SMMI (−16%), VFI (−46%), TBWI (−13%) and ECWI (−14%). For women, FFMI was significantly associated with LV mass/height 2 ( r = 0.41) and VFI for men ( r = 0.40). In the multivariable linear regression analysis, FFMI was the strongest significant predictor of cardiac wasting, with no significant interaction by sex or previous cardiotoxic therapy. Conclusions and Implications Cardiac wasting in advanced cancer is associated with lower FFMI and VFI independent of prior cardiotoxic therapy.

• Garcia, Jose M. & Laird, Barry James Anderson (2026). Cancer cachexia: progress, persistent challenges, and the need for alignment. Current opinion in supportive and palliative care. ISSN 1751-4258. 20(3), p. 153–154. doi: 10.1097/SPC.0000000000000806. Full text in Research Archive
• Foss, Line; Caraceni, Augusto Tomasso Giovanni; Centeno, Carlos; Chlebopaševienė, Greta; Clemmensen, Stine N. & Fraterman, Itske [Show all 16 contributors for this article] (2026). EU Joint Action: Integrating Palliative Care in the EU Cancer Agenda: Insights From JANE-2. Journal of Pain and Symptom Management. ISSN 0885-3924. 71(5). doi: 10.1016/j.jpainsymman.2026.02.009. Full text in Research Archive
• Yri, Olav Erich & Laird, Barry James Anderson (2025). Cancer pain – all change please? Clinical medicine (London). ISSN 1470-2118. 25(4). doi: 10.1016/j.clinme.2025.100341. Full text in Research Archive
• Hustad, Kristin Solheim; Kaasa, Stein & Laird, Barry J. (2025). Integrated nutritional care in cancer; About time? Current opinion in supportive and palliative care. ISSN 1751-4258. 19(3), p. 198–202. doi: 10.1097/SPC.0000000000000765. Full text in Research Archive
• Hustad, Kristin Solheim; Koteng, Lisa Heide; Urrizola, Amaia; Arends, J.; Bye, Asta & Dajani, Olav [Show all 71 contributors for this article] (2025). Practical cancer nutrition, from guidelines to clinical practice: a digital solution to patient-centred care. ESMO Open. 10(4). doi: 10.1016/j.esmoop.2025.104529. Full text in Research Archive Show summary

  Background Malnutrition affects 20%-70% of cancer patients, depending on tumour type, disease stage, and clinical setting. While nutritional care is essential for improving patients’ quality of life and clinical outcomes, it is not systematically integrated into routine cancer care. MyPath is a European Union project aiming to implement patient-centred care (PCC) at nine European cancer centres using implementation science. Multidisciplinary teams have developed standardised digitally supported PCC pathways based on patient-reported outcomes (PROs) with linked evidence-based management options. Through systematic assessment and management of common symptoms and psychosocial problems in cancer patients, MyPath aims to facilitate changes in clinical practice to improve PCC for all. As part of this, the MyPath Nutrition Care Pathway (NCP) aims to facilitate necessary clinical changes to routinely assess and address nutrition in all patients. Materials and methods Between September 2022 and August 2024, an international multidisciplinary team reviewed evidence-based nutrition guidelines to select relevant PROs and other variables necessary to systematically assess patients, allowing for tailored nutritional care. Results The MyPath NCP assessment relies on nutritional status (Malnutrition Screening Tool for malnutrition risk, modified Global Leadership Initiative on Malnutrition criteria for malnutrition, and body mass index/weight change for obesity/unintentional weight gain), health status (functional status, cancer diagnosis and prognosis, and prehabilitation needs), and inflammatory status (C-reactive protein levels). Based on this assessment, the digital solution suggests tailored, evidence-based nutritional interventions. Continuous monitoring through PROs and clinical consultations will customise care to patients’ dynamic nutritional needs. The first version of this digital solution will be piloted in 2025. Conclusions Inconsistent implementation of nutrition guidelines is a key challenge in cancer care. The MyPath NCP offers an accessible, patient-centred assessment and management system that integrates nutritional care into routine cancer care, providing a versatile solution that can be implemented across diverse health care settings.

• Laird, Barry James Anderson; Skipworth, Richard; Bonomi, Philip D.; Fallon, Marie; Kaasa, Stein & Giorgino, Ruben [Show all 8 contributors for this article] (2025). Anamorelin Efficacy in Non–Small-Cell Lung Cancer Patients With Cachexia: Insights From ROMANA 1 and ROMANA 2. Journal of Cachexia, Sarcopenia and Muscle. ISSN 2190-5991. 16(1). doi: 10.1002/jcsm.13732. Full text in Research Archive
• Dajani, Olav; Philips, Iain; Størkson, Ester Kristine; Balstad, Trude Rakel; Brown, Leo R. & Bye, Asta [Show all 23 contributors for this article] (2025). Oncological and Survival Endpoints in Cancer Cachexia Clinical Trials: Systematic Review 6 of the Cachexia Endpoints Series. Journal of Cachexia, Sarcopenia and Muscle. ISSN 2190-5991. 16(2), p. 1–24. doi: 10.1002/jcsm.13756. Full text in Research Archive
• Stene, Guro Birgitte; Hauken, May Aasebø; Ahmedzai, Hilde Hjelmeland; Storvestre, Constance Gaard; Vervik, Skjalg Eirik Holmefjord & Bayly, Joanne [Show all 16 contributors for this article] (2024). Integration of palliative rehabilitation in cancer care: a multinational mixed method study. BMC Palliative Care. 23(1). doi: 10.1186/s12904-024-01586-1. Full text in Research Archive Show summary

  Background: Incurable cancer is a major contributor to societal suffering and disability, and palliative rehabilitation is recommended to be integrated within and between cancer services at all healthcare levels. However, little knowledge exists on how integration of palliative rehabilitation in cancer is understood and achieved in clinical practice. INSPIRE (Integrated short-term palliative rehabilitation to improve quality of life and equitable care access in incurable cancer) is a large European-funded project that aims to promote quality of life through a novel rehabilitation model for people disabled by advanced cancer. Aim: To compare the existing integration of palliative rehabilitation in cancer within official documents and in clinical practice across five European countries including United Kingdom, France, Denmark, Norway, and Italy. Methods: Mixed methods study with a concurrent research design, comprising a document analysis (N = 23), stakeholder interviews (N = 22), and an online survey (N = 225). Data from each sub-study were analysed separately before results were merged. Results: There was limited integration of palliative rehabilitation in cancer in official documents and in clinical practice, though some indicators of integration, including participation in multidisciplinary teams and adherence to standardised pathways, were identified in the survey. Notably, integration of palliative rehabilitation in cancer in clinical practice was observed within limited organisations in secondary healthcare systems, without widespread adoption. Although palliative rehabilitation in cancer as a concept was sparingly used by stakeholders, they recognised the need for a comprehensive approach including multidisciplinary teams that aligns with the individual patient’s needs and goals. Moreover, the ambiguous distinction between the terms ‘palliative rehabilitation’ and ‘palliative care’, insufficient funding, lack of well-defined care pathways and competence gaps among healthcare professionals represented barriers to integration of palliative rehabilitation in cancer into clinical practice. Conclusion: Integration of palliative rehabilitation in cancer was limited in the five EU partnership countries investigated. Clarifying the concept of palliative rehabilitation, including adoption of the concept into official documents and delineating it from palliative care, is essential for more successful integration. This can possibly be achieved by addressing the barriers identified and fostering close collaboration across disciplines.

• Brown, Leo R.; Sousa, Mariana S.; Yule, Michael S.; Baracos, Vickie E.; McMillan, Donald C. & Arends, Jann [Show all 24 contributors for this article] (2024). Body weight and composition endpoints in cancer cachexia clinical trials: Systematic Review 4 of the cachexia endpoints series. Journal of Cachexia, Sarcopenia and Muscle. ISSN 2190-5991. 15(3), p. 816–852. doi: 10.1002/jcsm.13478. Full text in Research Archive Show summary

  Significant variation exists in the outcomes used in cancer cachexia trials, including measures of body composition, which are often selected as primary or secondary endpoints. To date, there has been no review of the most commonly selected measures or their potential sensitivity to detect changes resulting from the interventions being examined. The aim of this systematic review is to assess the frequency and diversity of body composition measures that have been used in cancer cachexia trials. MEDLINE, Embase and Cochrane Library databases were systematically searched between January 1990 and June 2021. Eligible trials examined adults (≥18 years) who had received an intervention aiming to treat or attenuate the effects of cancer cachexia for >14 days. Trials were also of a prospective controlled design and included body weight or at least one anthropometric, bioelectrical or radiological endpoint pertaining to body composition, irrespective of the modality of intervention (e.g., pharmacological, nutritional, physical exercise and behavioural) or comparator. Trials with a sample size of <40 patients were excluded. Data extraction used Covidence software, and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. This review was prospectively registered (PROSPERO: CRD42022276710). A total of 84 clinical trials, comprising 13 016 patients, were eligible for inclusion. Non-small-cell lung cancer and pancreatic cancer were studied most frequently. The majority of trial interventions were pharmacological (52%) or nutritional (34%) in nature. The most frequently reported endpoints were assessments of body weight (68 trials, n = 11 561) followed by bioimpedance analysis (BIA)-based estimates (23 trials, n = 3140). Sixteen trials (n = 3052) included dual-energy X-ray absorptiometry (DEXA)-based endpoints, and computed tomography (CT) body composition was included in eight trials (n = 841). Discrepancies were evident when comparing the efficacy of interventions using BIA-based estimates of lean tissue mass against radiological assessment modalities. Body weight, BIA and DEXA-based endpoints have been most frequently used in cancer cachexia trials. Although the optimal endpoints cannot be determined from this review, body weight, alongside measurements from radiological body composition analysis, would seem appropriate. The choice of radiological modality is likely to be dependent on the trial setting, population and intervention in question. CT and magnetic resonance imaging, which have the ability to accurately discriminate tissue types, are likely to be more sensitive and provide greater detail. Endpoints are of particular importance when aligned with the intervention's mechanism of action and/or intended patient benefit.

• Yule, Michael S.; Thompson, Joshua; Leesahatsawat, Khachonphat; Sousa, Mariana S.; Anker, Stefan D. & Arends, Jann [Show all 26 contributors for this article] (2024). Biomarker endpoints in cancer cachexia clinical trials: Systematic Review 5 of the cachexia endpoint series. Journal of Cachexia, Sarcopenia and Muscle. ISSN 2190-5991. 15(3), p. 853–867. doi: 10.1002/jcsm.13491. Full text in Research Archive Show summary

  Regulatory agencies require evidence that endpoints correlate with clinical benefit before they can be used to approve drugs. Biomarkers are often considered surrogate endpoints. In cancer cachexia trials, the measurement of biomarkers features frequently. The aim of this systematic review was to assess the frequency and diversity of biomarker endpoints in cancer cachexia trials. A comprehensive electronic literature search of MEDLINE, Embase and Cochrane (1990–2023) was completed. Eligible trials met the following criteria: adults (≥18 years), prospective design, more than 40 participants, use of a cachexia intervention for more than 14 days and use of a biomarker(s) as an endpoint. Biomarkers were defined as any objective measure that was assayed from a body fluid, including scoring systems based on these assays. Routine haematology and biochemistry to monitor intervention toxicity were not considered. Data extraction was performed using Covidence, and reporting followed PRISMA guidance (PROSPERO: CRD42022276710). A total of 5975 studies were assessed, of which 52 trials (total participants = 6522) included biomarkers as endpoints. Most studies (n = 29, 55.7%) included a variety of cancer types. Pharmacological interventions (n = 27, 51.9%) were most evaluated, followed by nutritional interventions (n = 20, 38.4%). Ninety-nine different biomarkers were used across the trials, and of these, 96 were assayed from blood. Albumin (n = 29, 55.8%) was assessed most often, followed by C-reactive protein (n = 22, 42.3%), interleukin-6 (n = 16, 30.8%) and tumour necrosis factor-α (n = 14, 26.9%), the latter being the only biomarker that was used to guide sample size calculations. Biomarkers were explicitly listed as a primary outcome in six trials. In total, 12 biomarkers (12.1% of 99) were used in six trials or more. Insulin-like growth factor binding protein 3 (IGFBP-3) and insulin-like growth factor 1 (IGF-1) levels both increased significantly in all three trials in which they were both used. This corresponded with a primary outcome, lean body mass, and was related to the pharmacological mechanism. Biomarkers were predominately used as exploratory rather than primary endpoints. The most commonly used biomarker, albumin, was limited by its lack of responsiveness to nutritional intervention. For a biomarker to be responsive to change, it must be related to the mechanism of action of the intervention and/or the underlying cachexia process that is modified by the intervention, as seen with IGFBP-3, IGF-1 and anamorelin. To reach regulatory approval as an endpoint, the relationship between the biomarker and clinical benefit must be clarified.

• Blum, David; Vagnildhaug, Ola Magne; Stene, Guro Birgitte; Maddocks, Matthew; Sørensen, Jonas & Laird, Barry J [Show all 12 contributors for this article] (2023). Top Ten Tips Palliative Care Clinicians Should Know About Cachexia. Journal of Palliative Medicine. ISSN 1096-6218. 26(8), p. 1133–1138. doi: 10.1089/jpm.2022.0598. Full text in Research Archive Show summary

  Cachexia is a multifactorial syndrome that is common in cancer and chronic disease. It is often underdiagnosed and therefore goes untreated or undertreated. Cachexia causes suffering across biopsychosocial domains and affects patients and their loved ones. In this article, a group of clinicians and researchers across cancer care, nutrition, and exercise offers tips about assessment, classification, and management of cachexia, with attention to its stage. The required multimodal management of cachexia mirrors well the interprofessional collaboration that is the mainstay of interdisciplinary palliative care and attention to screening, diagnosis, and management of cachexia is critical to maximize patients' quality of life.

• Bayly, Joanne; Ahmedzai, Hilde Hjelmeland; Blandini, Maria Grazia; Bressi, Barbara; Caraceni, Augusto Tomasso Giovanni & Vasconcelos, Joana Carvalho [Show all 24 contributors for this article] (2023). Integrated Short-term Palliative Rehabilitation to improve quality of life and equitable care access in incurable cancer (INSPIRE): a multinational European research project. Palliative Care & Social Practice. 17. doi: 10.1177/26323524231179979. Full text in Research Archive Show summary

  Background: Disability related to incurable cancer affects over a million Europeans each year and people with cancer rank loss of function among the most common unmet supportive care needs. Objectives: To test the clinical and cost-effectiveness of an integrated short-term palliative rehabilitation intervention, to optimise function and quality of life in people affected by incurable cancer. Design: This is a multinational, parallel group, randomised, controlled, assessor blind, superiority trial. Methods: The INSPIRE consortium brings together leaders in palliative care, oncology and rehabilitation from partner organisations across Europe, with complementary expertise in health service research, trials of complex interventions, mixed-method evaluations, statistics and economics. Partnership with leading European civil society organisations ensures citizen engagement and dissemination at the highest level. We will conduct a multinational randomised controlled trial across five European countries, recruiting participants to assess the effectiveness of palliative rehabilitation for people with incurable cancer on the primary outcome – quality of life – and secondary outcomes including disability, symptom burden and goal attainment. To support trial conduct and enhance analysis of trial data, we will also conduct: comparative analysis of current integration of rehabilitation across oncology and palliative care services; mixed-method evaluations of equity and inclusivity, processes and implementation for the intervention, at patient, health service and health system levels. Finally, we will conduct an evidence synthesis, incorporating INSPIRE findings, and a Delphi consensus to develop an international framework for palliative rehabilitation practice and policy, incorporating indicators, core interventions, outcomes and integration methods. Scientific contribution: If positive, the trial could produce a scalable and equitable intervention to improve function and quality of life in people with incurable cancer and reduce the burden of care for their families. It could also upskill the practitioners involved and motivate future research questions. The intervention could be adapted and integrated into different health systems using existing staff and services, with little or no additional cost.

• McDonald, James; Sayers, Judith; Anker, Stefan D.; Arends, Jann; Balstad, Trude Rakel & Baracos, Vickie [Show all 29 contributors for this article] (2023). Physical function endpoints in cancer cachexia clinical trials: Systematic Review 1 of the cachexia endpoints series. Journal of Cachexia, Sarcopenia and Muscle. ISSN 2190-5991. doi: 10.1002/jcsm.13321. Full text in Research Archive Show summary

  In cancer cachexia trials, measures of physical function are commonly used as endpoints. For drug trials to obtain regulatory approval, efficacy in physical function endpoints may be needed alongside other measures. However, it is not clear which physical function endpoints should be used. The aim of this systematic review was to assess the frequency and diversity of physical function endpoints in cancer cachexia trials. Following a comprehensive electronic literature search of MEDLINE, Embase and Cochrane (1990–2021), records were retrieved. Eligible trials met the following criteria: adults (≥18 years), controlled design, more than 40 participants, use of a cachexia intervention for more than 14 days and use of a physical function endpoint. Physical function measures were classified as an objective measure (hand grip strength [HGS], stair climb power [SCP], timed up and go [TUG] test, 6-min walking test [6MWT] and short physical performance battery [SPPB]), clinician assessment of function (Karnofsky Performance Status [KPS] or Eastern Cooperative Oncology Group-Performance Status [ECOG-PS]) or patient-reported outcomes (physical function subscale of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaires [EORTC QLQ-C30 or C15]). Data extraction was performed using Covidence and followed PRISMA guidance (PROSPERO registration: CRD42022276710). A total of 5975 potential studies were examined and 71 were eligible. Pharmacological interventions were assessed in 38 trials (54%). Of these, 11 (29%, n = 1184) examined megestrol and 5 (13%, n = 1928) examined anamorelin; nutritional interventions were assessed in 21 trials (30%); and exercise-based interventions were assessed in 6 trials (8%). The remaining six trials (8%) assessed multimodal interventions. Among the objective measures of physical function (assessed as primary or secondary endpoints), HGS was most commonly examined (33 trials, n = 5081) and demonstrated a statistically significant finding in 12 (36%) trials (n = 2091). The 6MWT was assessed in 12 trials (n = 1074) and was statistically significant in 4 (33%) trials (n = 403), whereas SCP, TUG and SPPB were each assessed in 3 trials. KPS was more commonly assessed than the newer ECOG-PS (16 vs. 9 trials), and patient-reported EORTC QLQ-C30 physical function was reported in 25 trials. HGS is the most commonly used physical function endpoint in cancer cachexia clinical trials. However, heterogeneity in study design, populations, intervention and endpoint selection make it difficult to comment on the optimal endpoint and how to measure this. We offer several recommendations/considerations to improve the design of future clinical trials in cancer cachexia.

• Seymour-Jackson, Emily; Laird, Barry J; Sayers, Judith; Fallon, Marie; Solheim, Tora S & Skipworth, Richard (2023). Cannabinoids in the treatment of cancer anorexia and cachexia: Where have we been, where are we going? Asia-Pacific Journal of Oncology Nursing (APJON). ISSN 2347-5625. doi: 10.1016/j.apjon.2023.100292. Full text in Research Archive Show summary

  Cachexia–anorexia cancer syndrome remains an unmet clinical need with a dearth of treatment and no standard of care. Acting through the endocannabinoid system, cannabinoids are one potential cancer cachexia treatment. Herein, the potential mechanisms for cannabinoids for cancer cachexia are discussed as are previous and ongoing clinical trials.

• Fallon, M.; Dierberger, K.; Leng, M.; Hall, P.S.; Allende, S. & Sabar, R. [Show all 18 contributors for this article] (2022). An international, open-label, randomised trial comparing a two-step approach versus the standard three-step approach of the WHO analgesic ladder in patients with cancer. Annals of Oncology. ISSN 0923-7534. 33(12), p. 1296–1303. doi: 10.1016/j.annonc.2022.08.083. Full text in Research Archive Show summary

  Background Worldwide, cancer pain management follows the World Health Organization (WHO) three-step analgesic ladder. Using weak opioids (e.g. codeine) at step 2 is debatable with low-dose strong opioids being potentially better, particularly in low- and middle-income countries where weak opioids are expensive. We wanted to assess the efficiency, safety and cost of omitting step 2 of the WHO ladder. Patients and methods We carried out an international, open-label, randomised (1 : 1) parallel group trial. Eligible patients had cancer, pain ≥4/10 on a 0-10 numerical rating scale, required at least step 1 (paracetamol) of the WHO ladder and were randomised to the control arm (weak opioid, step 2 of the WHO ladder) or the experimental arm (strong opioid, step 3). Primary outcome was time to stable pain control (3 consecutive days with pain ≤3). Secondary outcomes included distress, opioid-related side-effects and costs. The primary outcome analysis was by intention to treat and the follow-up was for 20 days. Results One hundred and fifty-three patients were randomised (76 control, 77 experimental). There was no statistically significant difference in time to stable pain control between the arms, P = 0.667 (log-rank test). The adjusted hazard ratio for the control arm was 1.03 (95% confidence interval 0.72-1.49). In the control arm, 38 patients (53%) needed to change to a strong opioid due to ineffective analgesia. The median time to change was day 6 (interquartile range 4-11). Compared to the control arm, patients in the experimental arm had less nausea (P = 0.009) and costs were less. Conclusion This trial provides some evidence that the two-step approach is an alternative option for cancer pain management.

• Solheim, Tora Skeidsvoll; Vagnildhaug, Ola Magne; Laird, Barry J & Balstad, Trude Rakel (2019). Combining optimal nutrition and exercise in a multimodal approach for patients with active cancer and risk for losing weight: Rationale and practical approach. Nutrition - The International Journal of Applied and Basic Nutritional Sciences. ISSN 0899-9007. 67-68:110541, p. 1–6. doi: 10.1016/j.nut.2019.06.022. Full text in Research Archive Show summary

  Weight loss and functional decline is a common and detrimental consequence of cancer. The interventions that are offered to patients with weight loss and functional decline often seem haphazard and varying from center to center. The lack of stringent management is probably based both on lack of knowledge of existing treatment guidelines and the current weak level of evidence of clinical effects of different nutritional and exercise interventions. Some studies evaluated multimodal interventions with various treatment combinations, including nutrition and exercise, that report clinically significant effects on cachexia outcomes. As of today, however, there is a paucity of large randomized controlled trials that incorporate both a fully structured exercise program and a well-described nutritional intervention. Studies investigating combinations of several interventions in patients with active cancer and risk for losing weight are too few and too heterogeneous to enable firm conclusions about effect, optimal dose, or timing of interventions. However, data presented in this review suggest an overall benefit, especially if interventions are started before weight loss and loss of function become too severe. Thus, the aim of this review was to examine the evidence for combined treatments targeting weight loss in cancer patients.

• Bye, Asta; Meli, Kari; Solheim, Tora Skeidsvoll; Laird, Barry J; Kaasa, Stein & Stene, Guro Birgitte [Show all 7 contributors for this article] (2019). Food intake by Patient-Generated Subjective Global Assessment (PG-SGA) corresponds to energy and protein intake as well as weight change in patients with advanced cancer. Clinical Nutrition Experimental. 25, p. 20–28. doi: 10.1016/j.yclnex.2019.03.003. Full text in Research Archive Show summary

  Background & aims The aim of this study was to test how well the Patient-Generated Subjective Global Assessment (PG-SGA) question about food intake correlates with a well-established measurement of food intake. Furthermore, we wanted to examine if there were any associations between the patients ratings to the question and weight change. Methods Data at baseline and after 4–6 weeks was drawn from two studies which combined provided a sample of 85 patients with lung and pancreatic cancer; one of the studies were an intervention study, the other a prospective, observational study. All patients completed the PG-SGA questionnaire, and rated their food intake the past month as unchanged, increased or less than usual. Energy and protein intake was estimated based upon a 24-h dietary recall. Results Patients reporting a food intake less than usual had a lower energy (24.2 vs 30.3 kcal/kg/day, p = 0.02) and protein (1.0 vs 1.2 g/kg/day, p = 0.07) intake at baseline compared to patients reporting unchanged or increased food intake. After comparison at 4–6 weeks, patients reporting a food intake less than usual, had a lower energy (24.5 vs 31.7 kcal/kg/day, p = 0.07) and protein (0.9 vs 1.3 g/kg/day, p = 0.003) intake. Patients reporting a food intake less than usual the past month lost more weight than patients with an unchanged or increased intake (−2.6 kg versus 0.7 kg respectively, p < 0.001). Conclusions This study show that self-reported food intake measured by PG-SGA corresponds to measured energy and protein intake as well to weight change on a group level. This indicates that patients self-report of food intake can be used as a valid indication of food intake in patients with advanced cancer. Further investigation of the psychometric properties of the question is necessary to evaluate how well the question performs on an individual level.

• Stene, Guro Birgitte; Balstad, Trude Rakel; Leer, Anne Silja Mäkitalo; Bye, Asta; Kaasa, Stein & Fallon, Marie T. [Show all 9 contributors for this article] (2019). Deterioration in muscle mass and physical function differs according to weight loss history in cancer cachexia. Cancers. 11(12), p. 1–14. doi: 10.3390/cancers11121925. Full text in Research Archive Show summary

  Background: Muscle mass and physical function (PF) are common co-primary endpoints in cancer cachexia trials, but there is a lack of data on how these outcomes interact over time. The aim of this secondary analysis of data from a trial investigating multimodal intervention for cancer cachexia (ClinicalTrials.gov: NCT01419145) is to explore whether changes in muscle mass and PF are associated with weight loss and cachexia status at baseline. Methods: Secondary analysis was conducted using data from a phase II randomized controlled trial including 46 patients with stage III–IV non-small cell lung cancer (n = 26) or inoperable pancreatic cancer (n = 20) due to commence chemotherapy. Cachexia status at baseline was classified according to international consensus. Muscle mass (assessed using computed tomography (CT)) and PF outcomes, i.e., Karnofsky performance status (KPS), self-reported PF (self-PF), handgrip strength (HGS), 6-minute walk test (6MWT), and physical activity (PA), were measured at baseline and after six weeks. Results: When compared according to cachexia status at baseline, patients with no/pre-cachexia had a mean loss of muscle mass (−5.3 cm2, p = 0.020) but no statistically significant change in PF outcomes. Patients with cachexia also lost muscle mass but to a lesser extent (−2.8 cm2, p = 0.146), but demonstrated a statistically significant decline in PF; KPS (−3.8 points, p = 0.030), self-PF (−8.8 points, p = 0.027), and HGS (−2.7 kg, p = 0.026). Conclusions: Weight loss history and cachexia status at baseline are of importance if one aims to detect changes in PF outcomes in cancer cachexia trials. To improve the use of co-primary endpoints that include PF in future trials, outcomes that have the potential to detect change relative to weight loss should be investigated further.

• Blackwood, Honor A.; Hall, Charlie C.; Balstad, Trude Rakel; Solheim, Tora Skeidsvoll; Fallon, Marie & Haraldsdottir, Erna [Show all 7 contributors for this article] (2019). A systematic review examining nutrition support interventions in patients with incurable cancer. Supportive Care in Cancer. ISSN 0941-4355. p. 1–13. doi: 10.1007/s00520-019-04999-4. Full text in Research Archive Show summary

  Purpose Recent guidelines by the European Society for Clinical Nutrition and Metabolism (ESPEN) have advocated increased attention to nutritional support in all patients with cancer; however, little is known about the optimal type of nutritional intervention. The aim of this review was to assess the current evidence for nutrition support in patients with incurable cancer. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Embase, MEDLINE and CINAHL were searched from 1990 to 2018. Evidence was appraised using a modified risk of bias table, based on guidance from the Cochrane Handbook for Systematic Reviews of Interventions. Results Sixty studies were assessed of which twelve met the eligibility criteria. Eleven studies examined body composition, with six studies reporting improvements in weight. Six studies examined nutritional status with three studies reporting an improvement. Nine studies examined nutritional intake with six showing improvements including significant improvements in dietary and protein intake. Ten studies examined quality of life, with six studies reporting improvements following intervention. The most common nutritional interventions examined were nutrition counselling and dietary supplementation. Conclusions There is moderate quality evidence to support the need for increased attention to nutrition support in patients with incurable cancer; however, despite some statistically significant results being reported, the clinical effects of them were small. Key questions remain as to the optimal timing for these interventions to be implemented (e.g. cachexia stage, illness stage and timing with anticancer therapy) and the most appropriate endpoint measures.

• Vagnildhaug, Ola Magne; Brunelli, Cinzia; Hjermstad, Marianne Jensen; Strasser, Florian; Baracos, Vickie & Wilcock, Andrew [Show all 10 contributors for this article] (2019). A prospective study examining cachexia predictors in patients with incurable cancer. BMC Palliative Care. 18:46, p. 1–10. doi: 10.1186/s12904-019-0429-2. Full text in Research Archive Show summary

  Background Early intervention against cachexia necessitates a predictive model. The aims of this study were to identify predictors of cachexia development and to create and evaluate accuracy of a predictive model based on these predictors. Methods A secondary analysis of a prospective, observational, multicentre study was conducted. Patients, who attended a palliative care programme, had incurable cancer and did not have cachexia at baseline, were amenable to the analysis. Cachexia was defined as weight loss (WL) > 5% (6 months) or WL > 2% and body mass index< 20 kg/m2. Clinical and demographic markers were evaluated as possible predictors with Cox analysis. A classification and regression tree analysis was used to create a model based on optimal combinations and cut-offs of significant predictors for cachexia development, and accuracy was evaluated with a calibration plot, Harrell’s c-statistic and receiver operating characteristic curve analysis. Results Six-hundred-twenty-eight patients were included in the analysis. Median age was 65 years (IQR 17), 359(57%) were female and median Karnofsky performance status was 70(IQR 10). Median follow-up was 109 days (IQR 108), and 159 (25%) patients developed cachexia. Initial WL, cancer type, appetite and chronic obstructive pulmonary disease were significant predictors (p ≤ 0.04). A five-level model was created with each level carrying an increasing risk of cachexia development. For Risk-level 1-patients (WL < 3%, breast or hematologic cancer and no or little appetite loss), median time to cachexia development was not reached, while Risk-level 5-patients (WL 3–5%) had a median time to cachexia development of 51 days. Accuracy of cachexia predictions at 3 months was 76%. Conclusion Important predictors of cachexia have been identified and used to construct a predictive model of cancer cachexia.

• Kersten, Christian; Cameron, Marte; Bailey, Andrew G; Fallon, Marie T.; Laird, Barry J & Paterson, Vicki [Show all 10 contributors for this article] (2019). Relief of Neuropathic Pain Through Epidermal Growth Factor Receptor Inhibition: A Randomized Proof-of-Concept Trial. Pain medicine (Malden, Mass.). ISSN 1526-2375. 20(12), p. 2495–2505. doi: 10.1093/pm/pnz101. Full text in Research Archive
• Habberstad, Ragnhild H; Frøseth, Trude Camilla Salvesen; Aass, Nina Kathrine; Abramova, Tatiana Mikhailovna; Baas, Theo & Mørkeset, Siri Tessem [Show all 24 contributors for this article] (2018). The Palliative Radiotherapy and Inflammation Study (PRAIS) - Protocol for a longitudinal observational multicenter study on patients with cancer induced bone pain. BMC Palliative Care. 17(110). doi: 10.1186/s12904-018-0362-9. Full text in Research Archive Show summary

  Background Radiation therapy (RT) results in pain relief for about 6 of 10 patients with cancer induced bone pain (CIBP) caused by bone metastases. The high number of non-responders, the long median time from RT to pain response and the risk of adverse effects, makes it important to determine predictors of treatment response. Clinical features such as cancer type, performance status and pain intensity, and biomarkers for osteoclast activity are proposed as predictors of response to RT. However, results are inconsistent and there is a need for better predictors of RT response. A similar argument can be stated for the development of cachexia; there are currently no predictors that can identify patients who will develop cachexia later in the cancer disease trajectory. Experimental and preclinical studies show that pain, depression and cachexia are related to inflammation. However, it is not known if inflammatory biomarkers can predict CIBP, depression or development of cachexia. Methods This multicenter, multinational longitudinal observational study will include 600 adult patients receiving RT for CIBP. Demographic data, clinical variables, osteoclast and inflammatory biomarkers will be assessed before start of RT, and 3, 8, 16, 24 and 52 weeks after last course of RT. The primary aim of the study is to identify potential predictors for pain relief from RT. Secondary aims are to explore potential predictors for development of cachexia, the longitudinal relationship between pain intensity and depression, and if inflammatory biomarkers are associated with changes in pain intensity, cachexia and depression during one-year follow up. Discussion The immediate clinical implication of the PRAIS study is to identify potential predictive factors for a RT response on CIBP, and thereby reduce non-efficacious RT. Patient benefits are fewer hospital visits, reduced risk of adverse effects and more individualized pain treatment. The long-term clinical implication of the PRAIS study is to improve the knowledge about inflammation in relation to CIBP, cachexia and depression and potentially identify associations and mechanisms that can be targeted for treatment. Trial registration ClinicalTrials.gov NCT02107664 , date of registration April 8, 2014 (retrospectively registered). Trial sponsor The European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, NTNU, Faculty of medicine and Health Sciences, Trondheim, N-7491, Norway.

• Laird, Barry J; Balstad, Trude Rakel & Solheim, Tora Skeidsvoll (2018). Endpoints in clinical trials in cancer cachexia: where to start? Current opinion in supportive and palliative care. ISSN 1751-4258. 12(4), p. 445–452. doi: 10.1097/SPC.0000000000000387. Full text in Research Archive Show summary

  Purpose of review The lack of agreement and knowledge of optimal endpoints in cachexia trials have impeded progress in finding interventions counteracting the devastating effects cancer cachexia has on morbidity and mortality. An endpoint should both be sensitive enough to detect change and specific enough not to be influenced by other conditions or treatments. Recent findings There is a wealth of potential and applied endpoints in trials investigating cachexia. As of today, there is no generally acknowledged consensus, but assessments of key factors such as body composition should continue to be applied. However, the impact and effect size necessary to achieve clinical benefit using these endpoints are not clear. Further, the use of other endpoints assessing physical function, symptom evaluation and quality of life remains to be elucidated. Summary It is essential that endpoints are clinically relevant and further research is therefore needed to develop endpoints that are meaningful for patients with cachexia.

• Simmons, Claribel P.L.; McMillan, Donald C.; McWilliams, Kerry; Sande, Tonje Anette; Fearon, Kenneth C. & Tuck, Sharon [Show all 8 contributors for this article] (2017). Prognostic tools in patients with advanced cancer: a systematic review. Journal of Pain and Symptom Management. ISSN 0885-3924. 53(5), p. 962–970.e10. doi: 10.1016/j.jpainsymman.2016.12.330. Full text in Research Archive
• Vagnildhaug, Ola Magne; Balstad, Trude Rakel; Almberg, Sigrun Saur; Brunelli, Cinzia; Knudsen, Anne Kari & Kaasa, Stein [Show all 9 contributors for this article] (2017). A cross-sectional study examining the prevalence of cachexia and areas of unmet need in patients with cancer. Supportive Care in Cancer. ISSN 0941-4355. p. 1–10. doi: 10.1007/s00520-017-4022-z. Full text in Research Archive Show summary

  Purpose The semantics of defining cancer cachexia over the last decade has resulted in uncertainty as to the prevalence. This has further hindered the recognition and subsequent treatment of this condition. Following the consensus definition for cancer cachexia in 2011, there is now a need to establish estimates of prevalence. Therefore the primary aim of the present study was to assess the prevalence of cachexia in an unselected cancer population. A secondary aim was to assess patient-perceived need of attention to cachexia. Methods A cross-sectional study in hospital patients was undertaken. Key inclusion criteria were: age >18 years, cancer diagnosis, and no surgery the preceding 24 hours. Data on demographics, disease, performance status, symptoms, cachexia and patients’ perceived need of attention to weight loss and nutrition was registered Results Data were available on 386 of 426 eligible patients. Median age (IQR) was 65 years (56-72), 214(55%) were male and 302(78%) had a performance status of 0-1 (Eastern Cooperative Oncology Group). Prevalence of cachexia (inpatients/outpatients) was 51%/22%. Prevalence was highest in patients with gastrointestinal cancer (62%/42%) and lung cancer (83%/36%). There was no major difference in prevalence between patients with metastatic (55%/24%) and localized disease (47%/19%). 20% of inpatients and 15% of outpatients wanted more attention to weight loss and nutrition. Cachexia (p<0.001), symptoms of mood disorder (p<0.001) and male gender (p<0.01) were independently associated with increased need of attention. Conclusion Cachexia is a prevalent condition, affecting both patients with localized and metastatic cancer. Clinical attention to the condition is a sizeable unmet need.

• Vagnildhaug, Ola Magne; Blum, David; Wilcock, Andrew; Fayers, Peter; Strasser, Florian & Baracos, Vickie E. [Show all 10 contributors for this article] (2017). The applicability of a weight loss grading system in cancer cachexia: a longitudinal analysis. Journal of Cachexia, Sarcopenia and Muscle. ISSN 2190-5991. 8(5), p. 789–797. doi: 10.1002/jcsm.12220. Full text in Research Archive Show summary

  Background A body mass index (BMI) adjusted weight loss grading system (WLGS) is related to survival in patients with cancer. The aim of this study was to examine the applicability of the WLGS by confirming its prognostic validity, evaluating its relationship to cachexia domains, and exploring its ability to predict cachexia progression. Methods An international, prospective observational study of patients with incurable cancer was conducted. For each patient, weight loss grade was scored 0–4. Weight loss grade 0 represents a high BMI with limited weight loss, progressing through to weight loss grade 4 representing low BMI and a high degree of weight loss. Survival analyses were used to confirm prognostic validity. Analyses of variance were used to evaluate the relationship between the WLGS and cachexia domains [anorexia, dietary intake, Karnofsky performance status (KPS), and physical and emotional functioning]. Cox regression was used to evaluate if the addition of cachexia domains to the WLGS improved prognostic accuracy. Predictive ability of cachexia progression was assessed by estimating proportion of patients progressing to a more advanced weight loss grade. Results One thousand four hundred six patients were analysed (median age 66 years; 50% female, 63% KPS ≤ 70). The overall effect of the WLGS on survival was significant as expressed by change in −2 log likelihood (P

• Paulsen, Ørnulf; Laird, Barry J; Aass, Nina Kathrine; Lea, Tor Erling; Fayers, Peter & Kaasa, Stein [Show all 7 contributors for this article] (2017). The relationship between pro-inflammatory cytokines and pain, appetite and fatigue in patients with advanced cancer. PLOS ONE. 12(5). doi: 10.1371/journal.pone.0177620. Full text in Research Archive Show summary

  Background Systemic inflammation is associated with reduced quality of life and increased symptoms in patients with advanced cancer. The aims of this study were to examine the relationships between inflammatory biomarkers and the Patient Reported Outcome Measures (PROMs) of pain, appetite and fatigue; and to explore whether levels of baseline biomarkers were associated with changes in these PROMs following treatment with corticosteroids. Material and methods An exploratory analysis was done on a trial examining the analgesic properties of corticosteroids in patients with advanced cancer. Inclusion criteria were: >18 years, taking opioids for moderate or severe cancer pain; pain ≥4 (numerical rating scale 0–10). Serum was extracted and levels of inflammatory biomarkers were assessed. PROMs of pain, appetite and fatigue were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). The relationships between PROMs and inflammatory biomarkers were examined using Spearman Rho-Rank and multiple regression analysis. Results Data were available on 49 patients. Levels of sTNF-r1, IL-6, IL-18, MIF, MCP-1, TGF-β1, IL-1ra, and C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were elevated; IL-1β, IL-2, IL-4, IL-8, IL-10, IL-12(p70), interferon-γ, MIP-1α, and TNF-α were below the level of detection. The following correlations were observed: appetite and IL-6 and CRP; fatigue and IL-1ra (rs: 0.38–0.41, p< .01). There was no association between pretreatment biomarkers and effect from corticosteroid treatment. Conclusion In patients with advanced cancer and pain, some pro-inflammatory cytokines were related to appetite and fatigue. Inflammatory biomarkers were not associated with pain or with the efficacy of corticosteroid therapy. Further research examining the attenuation of the systemic inflammatory response and possible effects on symptoms would be of interest.

• Solheim, Tora Skeidsvoll; Laird, Barry J; Balstad, Trude Rakel; Stene, Guro Birgitte; Bye, Asta & Johns, Neil [Show all 11 contributors for this article] (2017). A randomized phase II feasibility trial of a multimodal intervention for the management of cachexia in lung and pancreatic cancer. Journal of Cachexia, Sarcopenia and Muscle. ISSN 2190-5991. 8, p. 778–788. doi: 10.1002/jcsm.12201. Full text in Research Archive Show summary

  Background: Cancer cachexia is a syndrome of weight loss (including muscle and fat), anorexia, and decreased physical function. It has been suggested that the optimal treatment for cachexia should be a multimodal intervention. The primary aim of this study was to examine the feasibility and safety of a multimodal intervention (n-3 polyunsaturated fatty acid nutritional supplements, exercise, and anti-inflammatory medication: celecoxib) for cancer cachexia in patients with incurable lung or pancreatic cancer, undergoing chemotherapy. Methods: Patients receiving two cycles of standard chemotherapy were randomized to either the multimodal cachexia intervention or standard care. Primary outcome measures were feasibility assessed by recruitment, attrition, and compliance with intervention (>50% of components in >50% of patients). Key secondary outcomes were change in weight, muscle mass, physical activity, safety, and survival. Results: Three hundred and ninety-nine were screened resulting in 46 patients recruited (11.5%). Twenty five patients were randomized to the treatment and 21 as controls. Forty-one completed the study (attrition rate 11%). Compliance to the individual components of the intervention was 76% for celecoxib, 60% for exercise, and 48% for nutritional supplements. As expected from the sample size, there was no statistically significant effect on physical activity or muscle mass. There were no intervention-related Serious Adverse Events and survival was similar between the groups. Conclusions: A multimodal cachexia intervention is feasible and safe in patients with incurable lung or pancreatic cancer; however, compliance to nutritional supplements was suboptimal. A phase III study is now underway to assess fully the effect of the intervention.

• Fallon, Marie; Hoskin, Peter J.; Colvin, Lesley A.; Fleetwood-Walker, Susan M; Adamson, Douglas & Byrne, Anthony [Show all 8 contributors for this article] (2016). Randomized double-blind trial of pregabalin versus placebo in conjunction with palliative radiotherapy for cancer-induced bone pain. Journal of Clinical Oncology. ISSN 0732-183X. 34(6), p. 550–556. doi: 10.1200/JCO.2015.63.8221. Full text in Research Archive
• Kristensen, Are Korsnes; Vagnildhaug, Ola Magne; Grønberg, Bjørn Henning; Kaasa, Stein; Laird, Barry J & Solheim, Tora Skeidsvoll (2016). Does chemotherapy improve health-related quality of life in advanced pancreatic cancer? A systematic review. Critical Reviews in Oncology/Hematology. ISSN 1040-8428. 99, p. 286–298. doi: 10.1016/j.critrevonc.2016.01.006. Full text in Research Archive
• Laird, Barry J; Fallon, Marie; Hjermstad, Marianne Jensen; Tuck, Sharon; Kaasa, Stein & Klepstad, Pål [Show all 7 contributors for this article] (2016). Quality of life in patients with advanced cancer: Differential association with performance status and systemic inflammatory response. Journal of Clinical Oncology. ISSN 0732-183X. 34(23), p. 2769–2775. doi: 10.1200/JCO.2015.65.7742. Full text in Research Archive
• Hjermstad, Marianne Jensen; Aass, Nina Kathrine; Aielli, F; Bennett, Michael I.; Brunelli, Cinzia & Caraceni, Augusto [Show all 26 contributors for this article] (2016). Characteristics of the case mix, organization and delivery in cancer palliative care: a challenge for good-quality research. BMJ Supportive & Palliative Care. ISSN 2045-435X. 8(4), p. 456–467. doi: 10.1136/bmjspcare-2015-000997. Full text in Research Archive
• MacLeod, Nicholas; Kelly, Caroline; Stobo, Jon; McMahon, Lynn; Taggart, Diann & Fallon, Marie [Show all 7 contributors for this article] (2016). Pain in malignant pleural mesothelioma: A prospective characterization study. Pain medicine (Malden, Mass.). ISSN 1526-2375. 17(11), p. 2119–2126. doi: 10.1093/pm/pnw061. Full text in Research Archive
• MacLeod, Nicholas; Chalmers, Anthony; O'Rourke, Noelle; Moore, Karen; Sheridan, Jonathan & Mcmahon, Lynn [Show all 11 contributors for this article] (2015). Is radiotherapy useful for treating pain in mesothelioma?: A Phase II trial. Journal of Thoracic Oncology. ISSN 1556-0864. 10(6), p. 944–950. doi: 10.1097/JTO.0000000000000499. Full text in Research Archive
• Simmons, Claribel P; Koinis, Filippos; Fallon, Marie T.; Fearon, Kenneth C.; Bowden, Jo & Solheim, Tora Skeidsvoll [Show all 10 contributors for this article] (2015). Prognosis in advanced lung cancer - A prospective study examining key clinicopathological factors. Lung Cancer. ISSN 0169-5002. 88(3), p. 304–309. doi: 10.1016/j.lungcan.2015.03.020. Full text in Research Archive
• Kersten, Christian; Cameron, Marte; Laird, Barry J & Mjåland, Svein (2015). Epidermal growth factor receptor-inhibition (EGFR-I) in the treatment of neuropathic pain. British Journal of Anaesthesia. ISSN 0007-0912. 115(5), p. 761–767. doi: 10.1093/bja/aev326. Full text in Research Archive
• Mulvey, Matthew R.; Rolke, Roman; Klepstad, Pål; Caraceni, Augusto; Fallon, Marie & Colvin, Lesley [Show all 8 contributors for this article] (2014). Confirming neuropathic pain in cancer patients: Applying the NeuPSIG grading system in clinical practice and clinical research. Pain. ISSN 0304-3959. 155(5), p. 859–863. doi: 10.1016/j.pain.2013.11.010. Full text in Research Archive
• Sande, Tonje; Scott, A.C.; Laird, Barry J; Wan, H.I.; Fleetwood-Walker, S.M. & Kaasa, Stein [Show all 11 contributors for this article] (2014). The characteristics of physical activity and gait in patients receiving radiotherapy in cancer induced bone pain. Radiotherapy and Oncology. ISSN 0167-8140. 111(1), p. 18–24. doi: 10.1016/j.radonc.2013.10.023. Full text in Research Archive
• Laird, Barry J; Kaasa, Stein; McMillan, DC; Fallon, Marie T.; Hjermstad, Marianne Jensen & Fayers, Peter [Show all 7 contributors for this article] (2013). Prognostic Factors in Patients with Advanced Cancer: A Comparison of Clinicopathological Factors and the Development of an Inflammation-Based Prognostic System. Clinical Cancer Research. ISSN 1078-0432. 19(19), p. 5456–5464. doi: 10.1158/1078-0432.CCR-13-1066. Full text in Research Archive
• Bennett, Michael I; Laird, Barry J; Litsenburg, C van & Nimour, M (2013). Pregabalin for the Management of Neuropathic Pain in Adults with Cancer: A Systematic Review of the Literature. Pain medicine (Malden, Mass.). ISSN 1526-2375. 14(11), p. 1681–1688. doi: 10.1111/pme.12212. Full text in Research Archive Show summary

  Objective To systematically identify and appraise the current literature of pregabalin in the treatment of neuropathic pain resulting from cancer or cancer treatment. Design A systematic review of the literature was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Interventions and Subjects Studies reporting pregabalin data for adult (>18 years) patients with cancer experiencing neuropathic pain due to cancer or cancer treatment/surgery were considered eligible for inclusion. Methods A literature search was conducted in PubMed on February 22, 2012 using the following search terms: “neuropath* AND pain AND cancer OR oncology OR tumor OR tumour AND pregabalin.” Open access journals were also searched. Abstracts were screened and reviewed for eligibility based on predetermined criteria for inclusion. Data reporting pain intensity, pain interference, quality of life, symptom quality and intensity, global impression of change, treatment satisfaction, and adverse effects were the predefined factors for analysis. Data were summarized descriptively due to variations in study outcome measures. Results Five articles were eligible for inclusion; one double-blind National Cancer Institute common toxicity criteria controlled trial, one single-arm open-label study, two observational analyses, and one case report. Conclusions There were limited published data reporting efficacy and safety outcomes for pregabalin in the treatment of neuropathic pain in adult patients with cancer. Due to limitations within the studies included in this review, it is not possible to draw any conclusions on the descriptive summary of pregabalin for the treatment of cancer-related neuropathic pain, and further studies are required.

• Laird, Barry J; McMillan, DC; Fayers, Peter; Fearon, Kenneth C.; Kaasa, Stein & Fallon, Marie T. [Show all 7 contributors for this article] (2013). The Systemic Inflammatory Response and Its Relationship to Pain and Other Symptoms in Advanced Cancer. The Oncologist. ISSN 1083-7159. 18(9), p. 1050–1055. doi: 10.1634/theoncologist.2013-0120. Full text in Research Archive
• Foley, Peter L.; Vesterinen, Hanna M.; Laird, Barry J; Sena, Emily S.; Colvin, Lesley A. & Chandran, Siddhartan [Show all 8 contributors for this article] (2013). Prevalence and natural history of pain in adults with multiple sclerosis: Systematic review and meta-analysis. Pain. ISSN 0304-3959. 154(5), p. 632–642. doi: 10.1016/j.pain.2012.12.002. Full text in Research Archive

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• Shkodra, Morena & Laird, Barry J. (2025). Pioneering palliative care in the digital era. Current opinion in supportive and palliative care. ISSN 1751-4258. doi: 10.1097/SPC.0000000000000776. Full text in Research Archive
• Caraceni, Augusto Tomasso Giovanni; Laird, Barry James Anderson; Hjermstad, Marianne Jensen; Koteng, Lisa Heide; Sjøgren, Per & Kaasa, Stein (2024). From Vision to Reality: The Evolution of Palliative Care in European Oncology | Oncopedia. Oncopedia. doi: https:/www.oncopedia.wiki/contributions/from-vision-to-reality-the-evolution-of-palliative-care-in-european-oncology. Full text in Research Archive Show summary

  Palliative care, a patient-centred approach that addresses the physical, emotional, spiritual, and social needs of individuals with life-limiting illnesses, has become an essential component of modern cancer care. By combining cutting-edge research, compassionate care, and effective symptom management, palliative care has demonstrated its ability to significantly improve the quality of life for patients with cancer. Herein a historical exploration of the evolution of palliative care in Europe is described within the context of cancer care. The origins of palliative care are traced, with a particular focus on the development of the first modern hospice and its impact on the field. The challenges and successes of integrating palliative care into the broader oncology landscape is explored, including the development of specialised palliative care teams and the integration of palliative care principles into routine cancer care. Research in the field of palliative care, including advancements in symptom management, pain control, and end-of-life care is appraised and the emerging trends and challenges in palliative care (e.g. adapting to a changing oncology landscape) are discussed. By understanding the evolution of palliative care in European cancer care, we can gain valuable insights into its current state and future potential. Our aim is to provide a comprehensive overview of the field, highlighting its significance in improving the quality of life for patients with cancer and its ongoing contributions to healthcare.

• Fallon, M.T.; Caraceni, Augusto Tomasso Giovanni; Laird, Barry J & Kaasa, Stein (2023). Reply to the Letter to the Editor “A simple way of doing the complex but utmost important things: cancer pain management” by S. Singhal, M. Verma and D. Kukreja. Annals of Oncology. ISSN 0923-7534. 34(5), p. 496–497. doi: 10.1016/j.annonc.2023.02.005. Full text in Research Archive
• Vagnildhaug, Ola Magne; Brunelli, Cinzia; Hjermstad, Marianne Jensen; Strasser, Florian; Baracos, Vickie E. & Wilcock, Andrew [Show all 10 contributors for this article] (2018). A prospective study examining cachexia predictors in patients with incurable cancer. Full text in Research Archive Show summary

  Background A predictive model of cachexia development would help identify those at greatest risk for early therapeutic intervention. The aims of this study were to identify predictors of cachexia development and to use these to create and evaluate the accuracy of a predictive model. Methods A secondary analysis of an international, prospective, observational multicentre study was conducted. Patients with incurable cancer and without cachexia, who attended a palliative care unit were amenable to the analysis. Cachexia was defined as weight loss (WL) >5% (6 months) or WL>2% and body mass index<20kg/m2. Disease related, demographic and patient reported markers were evaluated as possible predictors with Cox analysis. The predictor “cancer type” was divided into high risk (pancreatic or gastric cancer), low risk (sarcoma, breast or hematologic cancer) or neutral risk (all others). A classification and regression tree analysis was used to create a model based on optimal combinations and cut-offs of significant predictors for cachexia development, and accuracy was evaluated with receiver operating characteristic curve analysis. Results 628 patients, 57% female, were included in the analysis. Median (IQR) age was 65 (17) years and Karnofsky performance status 70 (10). Median (IQR) follow-up was 109 (108) days, and 159 (25%) patients developed cachexia. Initial WL, cancer type, appetite and chronic obstructive pulmonary disease were significant predictors (p≤0.04). A four-level model was created with each level carrying an increasing risk of cachexia development. Level 1-patients (WL<3%, low risk cancer type and no or little appetite loss) had a relative hazard ratio (RHR) of 0.27 of cachexia development, while level 4-patients (WL 3-5%) had a RHR of 4.9. Accuracy of cachexia predictions at 3 months was 76%, and a risk level ≥3 (1-3% WL and neutral risk cancer type OR <3% weight loss and high risk cancer type) yielded a sensitivity of 46% and a specificity of 90% of cachexia development. Conclusion Important predictors of cachexia have been identified and used to construct a predictive model of cancer cachexia. Patients with a risk level ≥3 have a high risk of cachexia development, and should be targeted for therapeutic intervention.

• Simmons, Claribel P.; Koinis, Filippos; Fallon, Marie T.; Fearon, Kenneth C.; Bowden, Jo & Solheim, Tora Skeidsvoll [Show all 10 contributors for this article] (2017). Corrigendum to "Prognosis in advanced lung cancer ? A prospective study examining key clinicopathological factors". Lung Cancer. ISSN 0169-5002. 108, p. 256–256. doi: 10.1016/j.lungcan.2017.04.015. Full text in Research Archive
• Vagnildhaug, Ola Magne; Almberg, Sigrun Saur; Thronæs, Morten; Knudsen, Anne Kari; Brunelli, Cinzia & Kaasa, Stein [Show all 8 contributors for this article] (2017). Cancer cachexia ̶ prevalence and patient-perceived need of health care attention. Journal of Cachexia, Sarcopenia and Muscle. ISSN 2190-5991. 8, p. 161–183. doi: 10.1002/jcsm.12182. Full text in Research Archive Show summary

  Background There is considerable variance in prevalence estimates of cancer cachexia due to the heterogeneity of cachexia definitions. Lack of knowledge about cachexia among health care professionals has led to under-recognition and avoidance of the topic when faced with the patient. The objectives of this study are to provide an accurate estimate of cachexia prevalence in a general cancer population, to assess patient-perceived needs of attention to weight loss and nutrition, and to explore which factors signal such a need. Methods A cross-sectional study was undertaken in adult in- and outpatients with cancer at three different hospitals in Central-Norway. Trained personnel reported on disease specific items, while patients self-reported demographic data, weight, symptom intensity scores and need of health care personnel’s attention to weight loss and nutrition. Cachexia was defined as a) weight loss >5% or b) weight loss >2% and BMI <20kg/m2. Prevalence of cachexia as well as patient-perceived need of clinical attention to cachexia was estimated. Linear regression was used to explore which factors were associated with such a need. Results Data were available on 386 of 426 eligible patients. Median age (IQR) was 65(56-72), 214(55%) were male and 302(78%) had a performance status of 0-1 (ECOG). Prevalence of cachexia (inpatients/outpatients) was 51%/22%. Prevalence was highest in patients with gastrointestinal cancer (61%/42%) and lung cancer (83%/38%). There was no major difference in prevalence between patients with metastatic disease (55%/24%) and localized disease (47%/19%). 20% of inpatients and 15% of outpatients said they wanted more attention to weight loss and nutrition. Weight loss (p<0.001), depression and anxiety symptoms (p<0.001) and male gender (p=0.004) were independent factors associated with an increased need of attention. Conclusion Cachexia is a prevalent condition, affecting both patients with localized and metastatic cancer. Clinical attention to the condition is a sizeable unmet need.

• Meli, Kari; Bye, Asta; Balstad, Trude Rakel; Hjermstad, Marianne Jensen; Skjegstad, Grete S & Laird, Barry J [Show all 9 contributors for this article] (2016). Weight loss and survival in advanced cancer in relation to inadequate energy intake. Full text in Research Archive
• Vagnildhaug, Ola Magne; Almberg, Sigrun Saur; Thronæs, Morten; Knudsen, Anne Kari; Brunelli, Cinzia & Kaasa, Stein [Show all 8 contributors for this article] (2016). Cancer cachexia ̶ prevalence and patient-perceived need of health care attention. Full text in Research Archive Show summary

  Background There is considerable variance in prevalence estimates of cancer cachexia due to the heterogeneity of cachexia definitions. Lack of knowledge about cachexia among health care professionals has led to under-recognition and avoidance of the topic when faced with the patient. The objectives of this study are to provide an accurate estimate of cachexia prevalence in a general cancer population, to assess patient-perceived needs of attention to weight loss and nutrition, and to explore which factors signal such a need. Methods A cross-sectional study was undertaken in adult in- and outpatients with cancer at three different hospitals in Central-Norway. Trained personnel reported on disease specific items, while patients self-reported demographic data, weight, symptom intensity scores and need of health care personnel’s attention to weight loss and nutrition. Cachexia was defined as a) weight loss >5% or b) weight loss >2% and BMI <20kg/m2. Prevalence of cachexia as well as patient-perceived need of clinical attention to cachexia was estimated. Linear regression was used to explore which factors were associated with such a need. Results Data were available on 386 of 426 eligible patients. Median age (IQR) was 65(56-72), 214(55%) were male and 302(78%) had a performance status of 0-1 (ECOG). Prevalence of cachexia (inpatients/outpatients) was 51%/22%. Prevalence was highest in patients with gastrointestinal cancer (61%/42%) and lung cancer (83%/38%). There was no major difference in prevalence between patients with metastatic disease (55%/24%) and localized disease (47%/19%). 20% of inpatients and 15% of outpatients said they wanted more attention to weight loss and nutrition. Weight loss (p<0.001), depression and anxiety symptoms (p<0.001) and male gender (p=0.004) were independent factors associated with an increased need of attention. Conclusion Cachexia is a prevalent condition, affecting both patients with localized and metastatic cancer. Clinical attention to the condition is a sizeable unmet need.

• Leer, Anne Silja Mäkitalo; Solheim, Tora Skeidsvoll; Bye, Asta; Laird, Barry J; Fearon, Kenneth & Kaasa, Stein [Show all 8 contributors for this article] (2016). Evaluation of Physical Function Outcomes Related to Change in Muscle Mass in Patients with Cancer Cachexia. Palliative Medicine. ISSN 0269-2163. doi: 10.1177/0269216316646056. Full text in Research Archive
• Leer, Anne Silja Mäkitalo; Solheim, Tora Skeidsvoll; Bye, Asta; Laird, Barry J; Fearon, Kenneth & Kaasa, Stein [Show all 8 contributors for this article] (2016). Evaluation of Physical Function Outcomes Related to Change in Muscle Mass in Patients with Cancer Cachexia. Full text in Research Archive
• Kaasa, Stein; Solheim, Tora Skeidsvoll; Laird, Barry J; Balstad, Trude Rakel; Stene, Guro Birgitte & Bye, Asta [Show all 9 contributors for this article] (2015). A randomised, open-label trial of a Multimodal Intervention (Exercise, Nutrition and Anti-inflammatory Medication) plus standard care versus standard care alone to precent / attenuate cachexia in advanced cancer patients undergoing chemotherapy. Full text in Research Archive
• Balstad, Trude Rakel; Pettersen, Caroline Hild; Laird, Barry J; Fearon, Ken; Schønberg, Svanhild Margrethe Arentz & Skorpen, Frank [Show all 9 contributors for this article] (2015). Changes in plasma levels of n-3 fatty acids in response to n-3 fatty acid enriched supplementation in advanced cancer patients. Full text in Research Archive
• Vagnildhaug, Ola Magne; Blum, David; Wilcock, Andrew; Fayers, Peter; Strasser, Florian & Baracos, Vickie [Show all 10 contributors for this article] (2015). Late breaking abstract: Cancer cachexia classification in a large longitudinal patient cohort. Full text in Research Archive
• Balstad, Trude Rakel; Solheim, Tora Skeidsvoll; Laird, Barry J; Fearon, Kenneth C.H.; Kaasa, Stein & Bye, Asta (2014). Feasibility of dietary counseling to attenuate cachexia in patients with advanced cancer. Full text in Research Archive
• Scott, Angela C; Sande, Tonje; Laird, Barry J; Wan, H.I.; Fleetwood-Walker, S.M. & Kaasa, Stein [Show all 11 contributors for this article] (2013). The Relationship Between Subjective Assessment of Pain and the Objective Assessment of Gait and Physical Function in Patients Receiving Radiotherapy for Painful Bone Metastases. European Journal of Palliative Care. ISSN 1352-2779. p. 149–150. Full text in Research Archive

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