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CompletedNCT00497380Updated Sep 30, 2025

Arginine Feeding: a Novel Strategy to Improve Protein Metabolism in Cancer and the Response to Surgery

An interventional study of Arginine in Protein Metabolism, sponsored by Texas A&M University. Completed at 1 site in United States. Open to female participants aged 30 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-09-30.

Sponsored by Texas A&M University · Not applicable, Interventional, and Other

Phase
Not applicable
Study type
Interventional
Enrollment
19
Allocation
Randomized
Ages
30 Years and older
Sex
Female
01

Study summary

Muscle catabolism is a major problem in cancer patients undergoing surgery as it negatively affects post-operative recovery. Recent evidence exists that protein metabolic changes are already apparent in cancer before muscle wasting is being present. In line, patients with breast cancer, generally characterized by a normal nutritional status, were recently found to be arginine deficient. Arginine deficiency in cancer can be explained by: 1) Reduced arginine availability, due to exhaustion of endogenous (muscle) sources of arginine 2) Enhanced arginine catabolism, due to conversion of arginine by arginase, which is abundant in tumors. Protein is the most important endogenous source of arginine. Arginine deficiency will lead to a negative feedback loop in cachexia by promoting protein breakdown in an attempt to restore plasma arginine levels. We hypothesize that pre-operative arginine supplementation in breast cancer patients diminishes the occurrence of muscle wasting after surgery by 1) normalizing arginine availability pre-operatively, resulting in conservation of protein, 2) diminishing the catabolic effects of surgery by supplying exogenous arginine for the post-operative response, 3) enhancing the anabolic capacity to feeding through supplying substrate for protein synthesis.

Read the detailed description

In the present proposal, the effects of surgery and cancer will be examined by comparing subjects undergoing breast surgery because of malignancy vs. prophylactic reasons (aim 1). Furthermore, the effects of one-week pre-operative protein feeding with or without enrichment with arginine on post-operative protein metabolism (aim 2) will be investigated in the cancer group. Variables of interest are: 1. Whole-body and skeletal muscle protein metabolism, whole body arginine turnover and de-novo arginine production rate, and the anabolic capacity to feeding(assessed by stable isotope methodology). 2. Body weight, muscle mass and functional status, score for well-being (assessed by Profile of Mood State and Mini Mental State).

In the present study, we propose that a nutritional supplement that is high in protein content and enhanced in arginine will be more effective than a typical commercial nutritional supplement in diminishing the catabolic effects of surgery in subjects with cancer, thereby optimizing their quality of life. If this is found to be the case, this would provide the basis for reformulating the nutritional composition in accord with the effects of cancer and surgery on protein metabolism.

02

Conditions studied

  • Protein Metabolism
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In context

Lead sponsor

Texas A&M University is the lead sponsor of 123 studies on the registry; 23 are open to participants now.

Of its 7 completed or terminated interventional studies of FDA-regulated products, 2 (29%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
30 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

Cancer groups (for aims 1 and 2)

  1. Recently diagnosed (up to 4 weeks prior to treatment for cancer) with stage I, II or III invasive breast cancer
  2. Undergoing mastectomy
  3. Age greater than 30 years
  4. Ability to sign informed consent
  5. Good performance status defined by ECOG scale 0,1 or 2 (see CRF performance status)

Control group (for aim 1)

  1. Age greater than 30 years
  2. Undergoing prophylactic mastectomy
  3. Ability to sign informed consent
  4. Good performance status defined by ECOG scale 0,1 or 2 (see CRF performance status)

Exclusion criteria

Exclusion Criteria:

All groups (aim 1 and 2)

  1. Body weight loss of greater than 10% in the past 3 months
  2. Previous anti-cancer therapy (e.g. chemotherapy or radiotherapy) or surgery less than 4 weeks prior to the experiment
  3. Diagnosed diabetes type I or II
  4. Untreated metabolic diseases including liver or renal disease
  5. Any documented autoimmune disease
  6. Use of corticosteroids, beta-antagonists or nitrovasodilators
  7. Use of supplements enriched with amino acids
  8. Presence of acute illness or metabolically unstable chronic illness
  9. Unstable heart disease requiring therapy or recent myocardial infarction (less than 1 year)
  10. Current alcohol or drug abuse (ETOH more than 2 servings per day)
  11. Allergy/intolerance to any of the ingredients of the study products
  12. Any other condition deemed by the PI and the study physician as exclusion or that interferes with proper conduct of the study/ safety of the patient.
05

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
19 participants (actual)

Study arms

  • Experimental
    Arginine enriched nutrition

    Dietary Supplement: Arginine

  • Placebo comparator
    Nutrition

    Dietary Supplement: Arginine

Interventions

  • Dietary supplementArginine

    Oral nutritional supplement

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What researchers measure

Primary outcomes

  1. Net protein balance

    Time frame: end of study

Secondary outcomes

  1. Arginine turnover

    Time frame: end of study

07

Study locations

1 site
  • University of Arkansas for Medical Sciences
    Little Rock, Arkansas 72205, United States
08

References and documents

Publications

  • Engelen MPKJ, Klimberg VS, Allasia A, Deutz NEP. Major surgery diminishes systemic arginine availability and suppresses nitric oxide response to feeding in patients with early stage breast cancer. Clin Nutr. 2018 Oct;37(5):1645-1653. doi: 10.1016/j.clnu.2017.07.019. Epub 2017 Aug 5. PubMed 28826699 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 30, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00497380
Lead sponsor
Texas A&M University
Responsible party
Marielle PKJ Engelen, PhD (PhD, Texas A&M University) — Principal investigator
First posted
Jul 6, 2007
Start date
Aug 18, 2009
Primary completion
Feb 4, 2012
Completion
Feb 4, 2012
Last update
Sep 30, 2025

Study contacts

Nicolaas Deutz, M.D., Ph.D.
principal investigator · University of Arkansas

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2025. You cannot join it, but the record below documents what was studied.

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