Attenuation of exaggerated post-prandial gut hormone response: A novel therapeutic strategy for the treatment of excessive weight loss among disease-free post-oesophagectomy patients

There is increasing incidence of cancer of the oesophagus (the gullet or swallowing tube). Improvements to treatment strategies for oesophageal cancer have produced an increasing population of patients who remain free from the disease recurrence in the long-term. Optimising long-term outcomes for these patients after treatment therefore represents an important clinical concern.
Surgery remains the cornerstone of treatment for patients with oesophageal cancer, but while surgical removal of the tumour (oesophagectomy) currently offers the best chance of cure, it is a major operation associated with significant risk for short and long-term complications. Patients can suffer; weight loss, poor nutrition, and related quality-of-life impairments are common problems among patients who attain long-term cancer remission after oesophagectomy. The mechanisms underlying these complex problems are not well understood and therefore treatment strategies for this patient group are limited.
Previous pilot studies by this group have shown that chemical messengers known as gut hormones are released from the gastrointestinal tract after eating food are also increased after oesophagectomy. This study hypothesise that weight loss after oesophagectomy is associated with an increased gut hormone response to meals, which causes reduced behavioural drive to continue eating and an increased sensation of fullness. Consequently, blocking this response may result increase food intake and improve nutritional status. To examine this hypothesis we aim to access a group of patients after oesophagectomy, for:
1. Observed gut hormone changes after surgery 2.The effect of gut hormone blockage on appetite 3.The effect of gut hormone blockage on food intake 4. Determine whether a medication blocking gut hormone responses in patients with weight loss after surgery will facilitate improved weight and nutritional status.
This project will address an important clinical problem and will provide strong evidence based research regarding a possible innovative treatment option for patients with weight loss and associated problems after oesophagectomy. This will have an easy and clear potential for direct application in the clinic.

Award Date
15 May 2016
Award Value
€224,929
Principal Investigator
Dr Jessie A Elliott
Host Institution
University College Dublin
Scheme
Research Training Fellowships for Healthcare Professionals