Is ATP (Adenosine 5′-Triphosphate), like STP®, a Performance-Enhancing Additive for the Tanks of Cancer Patients?

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Among 1000 patients with advanced cancer, Donnelly and Walsh (1) found that anorexia, weakness, and weight loss (⩾10% of premorbid weight) were among the 10 most bothersome signs and symptoms. Despite the impact of the cancer anorexia/cachexia syndrome, relatively few clinical trials target its palliation as their primary end point. Observations that the drugs megestrol acetate, dexamethasone, and cyproheptadine caused unwanted weight gain when they were used to treat other illnesses led to clinical trials in cancer patients with anorexia/cachexia. In this setting, these agents may stimulate appetite and permit some patients to regain weight but do not appear to increase lean tissue mass (2-4). Treatment with megestrol acetate causes a 5% or greater weight gain in only 20% of cancer patients with the anorexia/cachexia syndrome (2). This limited success underscores the need to identify therapeutic alternatives.

In this issue of the Journal, Agteresch et al. (5) describe a randomized, controlled trial studying adenosine 5'-triphosphate (ATP) infusions as therapy for cancer anorexia/cachexia in patients with non-small-cell lung cancer. This trial sought to determine the effect of ATP infusions on body weight change, muscle strength, serum albumin concentration, and quality-of-life scores.