Clinical significance of early interventional therapy of branched-chain amino acid granules in patients with hepatocellular carcinoma: Propensity score matching analysis

Abstract

We examined whether supplementation of branched-chain amino acid (BCAA) granules in an early stage of underlying liver disease (pretreatment serum albumin levels ≥ 3.6 g/dl) can improve overall survival (OS) after therapy for hepatocellular carcinoma (HCC) using propensity score matching analysis. We compared OS between patients treated with BCAA granules and control group patients in two propensity score matched cohorts (cohort 1: pretreatment serum albumin levels ≥ 3.6 g/dl and <4.0 g/dl, 111 pairs; cohort 2: pretreatment serum albumin levels ≥ 4.0 g/dl, 61 pairs). We also performed subgroup analyses according to HCC stage. In cohort 1 patients, the OS rate in the BCAA group (median follow-up period, 2.9 years) tended to be higher compared to that in the control group (median follow-up period, 2.6 years) (1- and 3-year OS rates; 97.2 and 75.5% in the BCAA group and 87.2 and 64.5% in the control group, P=0.072), whereas in cohort 2 patients, the difference in the two groups did not reach significance in terms of OS [1- and 3-year OS rates; 83.2 and 60.7% in the BCAA group (median follow-up period, 2.3 years) and 91.8 and 66.0% in the control group (median follow-up period, 2.9 years), P=0.871]. In subgroup analyses, in cohort 1, in patients with HCC stage III or IV, the OS rate in the BCAA group (n=37) was significantly higher compared to that in the control group (n=34) (P=0.017). In other subgroup analyses, no significant difference in the two groups was found in terms of OS. In conclusion, early interventional therapies using BCAA granules may be effective in some selected HCC patients.

Impact of the branched‐chain amino acid to tyrosine ratio and branched‐chain amino acid granule therapy in patients with hepatocellular carcinoma: A propensity score analysis

“…Conversely, BTR was not significantly associated with survival from liver‐related mortality. Nishikawa et al . reported that BCAA granule therapy significantly prolonged survival only in some patient populations (HCC Stage III or IV disease and albumin ≥ 3.6 g/dL and < 4.0 g/dL) in the subgroup analysis of their propensity score‐based study.…”

“…Conversely, BTR was not significantly associated with survival from liver-related mortality. Nishikawa et al 30 reported that BCAA granule therapy significantly prolonged survival only in some patient populations (HCC Stage III or IV disease and albumin ≥ 3.6 g/dL and < 4.0 g/dL) in the subgroup analysis of their propensity score-based study. Although our study did not evaluate patients stratified by albumin level, and focused on survival from liver-related mortality, intervention with BCAA granules prolonged survival in HCC patients at all stages, including III or IV.…”

Systematic review with meta‐analysis: Branched‐chain amino acid supplementation in liver disease

“…We subsequently assessed 161 full‐text articles of which 54 were eligible, including one article found via reference checking. We included 34 randomized controlled trials, 42–75 5 prospective case–control studies, 76–80 13 retrospective case–control studies 81–93 and two studies 94,95 did not describe study design representing a total of 5184 (2308 BCAA supplementation, 2876 disease‐controls). The risk of bias was high for all except one included randomized trials and serious for all nonrandomized studies (Figure S1).…”

“…A total of 34 studies investigating the effect of BCAA in special categories of patients with chronic liver disease after specific therapeutic interventions, were included (Tables S2-S7). [45][46][47][48][49][50][51][52][53][55][56][57][58][59][60][61][62][63][64]66,67,78,79,[83][84][85][87][88][89][90][91][92][93]95 Twenty-one of these studies were randomized controlled trials, [45][46][47][48][49][50][51][52][53][55][56][57][58][59][60][61]<...…”

A Special Amino-Acid Formula Tailored to Boosting Cell Respiration Prevents Mitochondrial Dysfunction and Oxidative Stress Caused by Doxorubicin in Mouse Cardiomyocytes

“…Our results offer to study cardiac activity with more adequate coming in vivo studies. A second limit of this study is the absence of exploration on the neoplastic potential of α5, although this seems to be cast doubt by increasing evidence that supplementation of amino acids-especially the BCAAs-is beneficial mainly in liver cancer, yet their role in the nutritional support of cancer patients remains to be clearly defined [65][66][67][68][69]. Similarly, we did not investigate with appropriate in vivo models whether the α5 supplementation can affect the antineoplastic efficacy of DOX.…”