Nutrient Intake and Nutritional Indexes in Adults With Metastatic Cancer on a Phase I Clinical Trial of Dietary Methionine Restriction

• Published in: Nutrition and cancer 2002-01, Vol.42 (2), p.158-166
• Main Authors: Epner, Daniel C, Morrow, Sydney, Wilcox, Mandi, Houghton, Jennifer L
• Format: Article
• Language: English
• Subjects: Adult; adults; adverse effects; Biological and medical sciences; body mass index; clinical trials; Combined treatment; diet therapy; dietary protein; Energy Intake; experimental diets; Humans; Medical sciences; metastasis; methionine; Methionine - administration & dosage; Methionine - blood; Miscellaneous; Neoplasm Metastasis; neoplasms; Neoplasms - metabolism; Neoplasms - therapy; patients; prealbumin; protein intake; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Treatment. General aspects; Tumors; Weight Loss
• ISSN: 0163-5581; 1532-7914
• DOI: 10.1207/S15327914NC422_2

Animal studies have shown that dietary methionine restriction selectively inhibits growth of a variety of human tumor xenografts but has relatively few deleterious effects on normal tissues. The objectives of the present study were to determine whether enteral methionine restriction is safe and tolerable in adults with metastatic cancer and whether it reduces plasma methionine levels. Eight patients with a variety of metastatic solid tumors were enrolled in a phase I clinical trial. A commercially available methionine-free medical food served as the primary dietary protein source for all patients. Patients were prescribed diets containing 0.6-0.8 g of protein, 25-35 kcal, and 2 mg of methionine per kilogram per day. Participants remained on the experimental diet for an average of 17.3 wk (range 8-39 wk). Plasma methionine levels fell from 21.6 ± 7.3 to 9 ± 4 μM within 2 wk, representing a 58% decline. Serum albumin and prealbumin levels remained stable or increased. Mean energy intake increased during participation compared with baseline, and protein intake was maintained at target levels. The only side effect was weight loss of ~0.5% of body mass index (0.5 kg) per week. We conclude that enteral dietary methionine restriction is safe and tolerable in adults with metastatic solid tumors and results in significant reduction in plasma methionine levels.