Nutritional and Metabolic Diseases

All Conditions

Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

Rare Diseases

Malnutrition

Lung Neoplasms

Kwashiorkor

Nutrition Disorders

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

Severe Acute Malnutrition

Acute Graft Versus Host Disease

Micronutrients

All Drugs and Chemicals

Other Dietary Supplements

Amino Acids

Vitamins

Omega 3 Fatty Acid

Leucine

Valine

Isoleucine

ONS will be consumed 3 times a day, for 8 weeks. Per serving/sachet ONS (±81g) contains 350 kcal of energy, 9 g of fat, 20 g of protein, 48 g of carbohydrates, 400 mg of DHA (Docosahexaenoic acid), 300 mg of EPA (Eicosapentaenoic Acid) 0.92 g of Omega-3, 1 g of L-Valine, 2.1 g of L-. Isoleucine 1.1 g, L-Leucine 2.1 g, Sodium 75 mg, 12 vitamins and 9 minerals. Consumed as a morning snack (between breakfast and lunch); afternoon snack (between lunch and dinner) and evening snack (before bedtime). Subject will also received dietary counseling for 8 weeks

only received dietary counseling for 8 weeks without ONS supplementation.

Per serving/sachet NUTRICAN (±81g) contains 350 kcal energy, 9 g fat, 20 g protein, 48 g carbohydrate, 400 mg DHA, 300 mg EPA, 0.92 g Omega-3, 1 g L-Valine, 1.1 g L-Isoleucine, 2.1 g L-Leucine, 75 mg sodium, 12 vitamins and 9 minerals.

NUTRICAN

Sri AP Simanullang, B.Pharm

Dedyanto H Saputra, MD

Elisna Syahruddin, Prof.PhD,dr

Elisna Syahruddin, Phd.MD

The goal of this clinical trial is to evaluate the efficacy oral nutrition supplement (ONS) in malnutrition/high risk malnutrition cancer patients. The main questions it aims to answer:

1. Are there differences in knowledge, attitude and behaviour scores in cancer patients who receive cancer-specific ONS compared to those who do not receive cancer-specific ONS?
2. Is there a difference in nutritional status as assessed by average body weight, body mass index (BMI), haemoglobin (Hb), and albumin levels in cancer patients who receive cancer-specific ONS compared to those who do not receive cancer-specific ONS?

This study uses an open label randomized clinical trial (RCT) design, double arm which allows subjects and researchers to know the interventions received by subjects conducted on cancer patient subjects. The study aims to compare knowledge, attitudes, and actions related to nutrition consumption through questionnaires, nutritional status assessed from anthropometry (BW and BMI), nutrient intake, as well as laboratory results (Hb, serum albumin), quality of life, and inflammatory markers (CRP, TNF-α, IL(interleukin)-1, IL-6) between the group of subjects who were given dietary counseling and ONS/oral nutrition supplement (intervention group) for 8 weeks compared to the group of subjects who only received dietary counseling and did not receive ONS (control group).

Subjects who meet the inclusion criteria will be randomized into 2 groups using the stratified block randomization method stratified by age, and cancer type. Randomization will be carried out using a system in the application by stratifying the age of the subject based on the categorical age which has been categorized into 18-45 years and \>45 years. For the type of cancer stratified into two, namely lung cancer and gynecology cancer according to the inclusion criteria. Both stratified will be randomized using excel application that will randomize 80 subjects at the beginning of the research study.

Effect of NUTRICAN to Improve Nutritional Status in Cancer Patients

The Effect of Oral Nutrition Supplement Formulas (ONS) and Diet Counseling on Improvement of Nutritional Status, Knowledge, Attitudes, and Behavior of Cancer Patients

all IPD that underlie results in a publication

To determine changes in nutrition consumption knowledge scores in cancer patients who received cancer-specific ONS compared to those who did not receive ONS after 8 weeks of intervention using questioner .

Interpretation Knowledge score (5 questions): good (score\>=8 ) moderate (score 5-8) poor (score 0-4);

To determine changes in nutrition consumption attitudes score in cancer patients who received cancer-specific ONS compared to those who did not receive ONS after 8 weeks of intervention using questioner .

Interpretation Attitude score (10 questions): good (score\>=30 ) moderate (score 21-30) poor (score 0-20)

To determine changes in nutrition consumption behavior in cancer patients who received cancer-specific ONS compared to those who did not receive ONS after 8 weeks of intervention using questioner .

Interpretation Behaviour score(10 questions): good (score\>=30 ) moderate (score 21-30) poor (score 0-20).

To determine changes in BW (body weight in kg) in cancer patients who received cancer-specific ONS compared to those who did not receive ONS after the 8-week intervention. The higher the increase in BW, the better.

To determine changes in BMI (body mass index in kg/m2) in cancer patients who received cancer-specific ONS compared to those who did not receive ONS after the 8-week intervention. The higher the increase in BMI, the better.

BMI is calculated as weight in kilograms divided by the square of the height in meters (kg/m2) and is categorized into four groups according to the cutoff points: underweight (\<18.5 kg/m2), normal weight (18.5-22.9 kg/m2), overweight (23-24.9 kg/m2), obese grade 1 (≥25-29 kg/m2) and obese grade 2 (\>29 kg/m2)

To determine changes in Hb (haemoglobin in mg/dL) level in cancer patients who received cancer-specific ONS compared to those who did not receive ONS after the 8-week intervention. The higher the increase in haemoglobin level, the better.

To determine changes in Albumin level (g/dL) in cancer patients who received cancer-specific ONS compared to those who did not receive ONS after the 8-week intervention. The higher the increase in albumin level, the better

Changes in calorie intake between ONS group vs control group after an 8-week intervention. Assessment of calorie intake using NutriSurvey 2007, Food Recall 2x24h \& Food Record 3x24h. The higher subject's calorie (kcal) intake ,the better.

Changes in protein intake between ONS group vs control group after an 8-week intervention. Assessment of protein intake using NutriSurvey 2007, Food Recall 2x24h \& Food Record 3x24h. The higher subject's protein (gram) intake ,the better

The change in quality of life between ONS group vs control group; assessed by QLC-C30 (Quality of Life Questionnaire Core-30) score after 8 weeks of intervention. QLC-C30 is a 30 item instrument meant to assess some of the different aspects that define the quality of life of cancer patients.

Interpretation of QLC-C30 score: a.Good ≥1000 b.Moderate = 500-1000 c.Poor ≤500

The change in inflammatory status between ONS group vs control group assessed by CRP(C-reactive protein in mg/L) level (using CRP Latex Kit) after the 8-week intervention. The lower the value of CRP, the better.

The change in inflammatory status between ONS group vs control group assessed by IL-1 (interleukin-1 in pg/ml) level (using IL-1 ELISA kit) after the 8-week intervention The lower the value of IL-1, the better.

The change in inflammatory status between ONS group vs control group assessed by IL-6 (interleukin-6 in pg/ml) level (using IL-6 ELISA kit) after the 8-week intervention. The lower the value of IL-6, the better.

The change in inflammatory status between ONS group vs control group assessed by TNF-α (Tumor necrosis factor alpha in pg/ml) level (using Kit Quantikine ELISA Human TNF- α) after the 8-week intervention. The lower the value of TNF-α, the better.

Persahabatan Hospital

Kalbe International Pte. Ltd

Digestive System Diseases

Symptoms and General Pathology

Esophageal Neoplasms

Body Weight

Gastrointestinal Neoplasms

Digestive System Neoplasms

Head and Neck Neoplasms

Gastrointestinal Diseases

Esophageal Diseases

Esophageal Cancer

As for patients in oral natural diet group, the the participants shall receive oral natural diet.

As for patients in oral nutrition supplement group, in addition to oral natural die, the participants shall receive oral enteral supplement providing 750-1500kcal/d.

As for patients in tube feeding group, in addition to oral natural die, the participants shall receive tube feeding nutrition supplement providing 750-1500kcal/d.

Oral nutrition supplement

As for patients in tube feeding group, in addition to oral natural die, the participants shall receive Tube feeding nutrition supplement providing 750-1500kcal/d.

Tube feeding nutrition supplement

Keneng Chen, M.D.

Liang Dai, M.D.

Yang Geng, Master

Zaicheng Yu, Master

Renquan Zhang, Master

Deruo Liu, M.D.

Zhipeng Ren, M.D.

Wei Guo, M.D.

Chun Chen, M.D.

Wenfeng Ye, M.D.

Guibin Qiao, M.D.

Ming He, M.D.

Jianqun Ma, M.D.

Xiaotian Shi, M.D.

Xiangning Fu, M.D.

Wenliang Liu, M.D.

Youbin Cui, M.D.

Hongxu Liu, M.D.

Hui Tian, M.D.

Zhou Wang, M.D.

Hong Hu, Master

Zhigang Li, M.D.

Shiping Guo, Master

Liang Bu, M.D.

Qixun Chen, M.D>

This clinical trial is designed to be a multi-center prospective observational study which shall compare the effect of different postoperative home nutrition modes on recent nutritional index (weight/BMI) of patients with esophageal cancer and recent outcomes. Different postoperative home nutrition modes adopted in this study includes oral natural diet, oral nutrition supplement and tube feeding.

STUDY BACKGROUND Esophageal cancer is a common cancer in China and due to its influence on diet intake, patients with esophageal cancer are often combined with nutrition deficiency, which causes relatively high nutrition risk to treatment. Studies conducted by Martin et al showed that the degree of body weight loss in patients with malignancy is related to BMI level and prognosis. The patients with severe body weight loss and low BMI have poor prognosis, especially for patients with esophageal cancer.

At present, perioperative nutrition support for patients with esophageal cancer has been recognized and has been recommended as routine in 2017 NCCN guideline. How to implement good home nutrition within one month after patient discharge and recover nutrition index as soon as possible has become a focus for esophageal surgeon.

Many clinical trials have already investigated enteral nutrition support approach during anti-cancer treatment period in patients with malignancy. However, only a few clinical trials are good designed. Therefore the investigators hope to via this multi-center prospective observational study to provide evidence for this question.

OBJECTIVES:

1. To explore the relationship between postoperative home nutrition support treatment approach and nutritional status of patients with esophageal cancer;
2. To explore the relationship between postoperative home nutrition support treatment approach and recent prognosis in patients with esophageal cancer;
3. To promote the standardized application of postoperative home nutrition support treatment for patients with esophageal cancer.\\

OUTLINE:

Included patients shall be divided into three groups according to the treatment plan of all centers, including oral natural diet, oral nutrition supplement and tube feeding. As for patients in oral natural diet group, the patients shall receive oral natural diet. As for patients in oral nutrition supplement group, in addition to oral natural die, the participants shall receive oral enteral supplement providing 750-1500kcal/d. As for patients in tube feeding group, in addition to oral natural die, the participants shall receive tube feeding enteral supplement providing 750-1500kcal/d.

All the included patients shall be followed up weekly within 1-3 weeks after discharge via telephone, at Day 30 after discharge and at Day 90 after discharge to assess the effectiveness and safety of different home nutrition supplement approaches.

PROJECTED ACCRUAL: A total of 600 patients will be accrued for this study.

Effect of Postoperative Family Nutrition Mode on Weight/BMI of Patients With Esophageal Cancer

Percentage of 5% body weight loss on Day 30 compared to the body weight at discharge

Completion ratio of different nutrition support approaches

Assessment on patients' quality of life using EORTC QLQ-C30 scale and QLQ-OG25 scale in different nutrition support approach groups and investigate the relationship between different nutrition support approaches and patients' quality of life

Assessment on complications of home enteral nutrition support

Delay and interruption ratio of adjuvant treatment including whether chemotherapy and radiotherapy can be implemented on time

Re-hospitalization ratio within 90 days after discharge

Sun Yat-sen University

Zhejiang Cancer Hospital

Shanghai Chest Hospital

China-Japan Friendship Hospital

Fudan University

Shandong Provincial Hospital

Hebei Medical University Fourth Hospital

Anyang Tumor Hospital

The First Affiliated Hospital of Anhui Medical University

First Affiliated Hospital Bengbu Medical College

Tongji Hospital

Shanxi Province Cancer Hospital

The Third Affiliated Hospital of Harbin Medical University

Liaoning Tumor Hospital & Institute

Wuhan General Hospital of Guangzhou Military Command

Second Xiangya Hospital of Central South University

The First Hospital of Jilin University

Chinese PLA General Hospital

Hunan Provincial People's Hospital

Fujian Cancer Hospital

Qilu Hospital of Shandong University

Union hospital of Fujian Medical University

Daping Hospital and the Research Institute of Surgery of the Third Military Medical University

Peking University Cancer Hospital & Institute

Doctor

Child Nutrition Disorders

Central Nervous System Stimulants

Analgesics

Psychotropic Drugs

Anti-Allergic Agents

Dermatologic Agents

Gastrointestinal Agents

Dronabinol

Cyproheptadine

Hallucinogens

Analgesics, Non-Narcotic

Neurotransmitter Agents

Hormones

Hormone Antagonists

Histamine H1 Antagonists

Histamine

Histamine phosphate

Histamine Antagonists

Serotonin

Standard of Care who have either weight gain, weight maintenance, or weight loss \<10%.

Those receiving ONS will be prescribed a standard ONS (1.0 kcal per mL) that will meet a minimum of 50% of estimated energy needs to promote weight gain but allow for continued regular dietary intakes. The ONS will be prescribed as 8oz (240mL) per dose at least once a day, but up to six times per day depending on estimated nutrient needs.

Those randomized to EN will have a feeding tube placed and started on tube feeds via a designated pump for overnight feeds, meeting at least 50% of estimated energy needs to allow for continued regular dietary intakes during the day.

Those receiving age-appropriate appetite stimulants will be provided either cyproheptadine or dronabinol. Subjects will be given cyproheptadine if they fall between the ages of 2-12 years of age and dronabinol if they are \>12 years of age or older.

8oz (240mL) per dose at least once a day, but up to six times per day depending on estimated nutrient needs. The formula will equate to 1.0kcal/mL

Oral Nutrition Supplement

EN will have a feeding tube placed and started on tube feeds via a designated pump for overnight feeds, meeting at least 50% of estimated energy needs

Tube Feed

0.25mg/kg/d divided BID. May titrate by 4mg increments to a max of 12mg/day.

5mg BID (before breakfast and lunch). May titrate by 2.5mg increments to max of 20mg/day

Diet education on high protein, high calorie food consumption

Standard of Care

Corey J Hawes, DCN, RD, CSO, CNSC, LD

Amanda M Harrington, MD

Kelly Zavitz, PharmD, BCPPS

Nearly 60% of pediatric patients diagnosed with cancer develop malnutrition caused by a combination of disease burden, side effects of chemotherapy, and the intensity of cancer treatment. These patients are known to have an increased risk of infection, treatment-related toxicity, inferior clinical outcomes, and increased risk of mortality. Malnutrition may progress to cancer cachexia, characterized by anorexia, increased inflammation, decreased fat, and decreased muscle mass with subsequent weight loss, which is associated with decreased overall survival.

The goal of the proposed research is to determine changes in body composition, weight status, and nutritional status between common nutrition interventions including oral nutrition supplements (ONS), appetite stimulants, and enteral nutrition (EN) among pediatric cancer patients. A secondary goal of this research is to utilize the findings to develop clinical nutrition guidelines for this patient population. The specific objective of the research proposed is to solve the lack of evidence to adequately treat nutritional deficits in the pediatric oncology population. Without this data, there is a lack of clinical consistency in the initiation and selection of appropriate nutrition interventions to provide a more definitive pathway of care. This study can help formulate a clinical guideline for this patient population before, during, and after treatment.

The investigators plan to enroll a minimum of 45 subjects between the ages of 2-18 years old, over the course of one year, including males and females of all ethnicities. The subject will be a newly diagnosed pediatric patient with cancer who will actively receive chemotherapy at UK Healthcare's Kentucky Children's Hospital (KCH).

All those who enroll will have a baseline ultrasound and biomarkers taken at enrollment. Participants will also receive 'standard of care' medical nutrition therapy (MNT) counseling at diagnosis for following a high protein/high-calorie diet. If any of the enrolled participants lose \>10% of the diagnosis weight, the participants will then be randomized to receive (1) oral nutrition supplements, (2) age-appropriate appetite stimulants, or (3) enteral nutrition via a feeding tube. At the point of randomization, participants will receive another ultrasound and biomarkers. Those randomized will then receive additional ultrasounds and biomarkers at 1 month and 3 months after randomization. The remaining patients that have either weight maintenance or weight gain, will be utilized as a comparator group and will receive an ultrasound at 3 months and 6 months from enrollment/diagnosis. Each group will have a goal of at least 10 patients per group.

Those receiving ONS will be prescribed a standard ONS (1.0 kcal per mL) that will meet a minimum of 50% of estimated energy needs to promote weight gain but allow for continued regular dietary intakes. The ONS will be prescribed as 8oz (240mL) per dose at least once a day, but up to six times per day depending on estimated nutrient needs. Those receiving age-appropriate appetite stimulants will be provided either cyproheptadine or dronabinol. Subjects will be given cyproheptadine if the participants fall between the ages of 2-12 years of age and dronabinol if the participants are \>12 years of age or older. Table 1 summarizes the medication dosage forms, initial and dose titration options, and precautions/contraindications of each appetite stimulant. Medication adjustments will be made within 2-4 weeks of initiation due to the variable peak effect times, and chemotherapy treatment plans dictating clinic follow-up. Those randomized to EN will have a feeding tube placed and started on tube feeds via a designated pump for overnight feeds, meeting at least 50% of estimated energy needs to allow for continued regular dietary intakes during the day. After placement of a feeding tube, an abdominal x-ray will be obtained per hospital policy to confirm the appropriate placement of the feeding tube prior to use to ensure the safety of using said feeding tube.

Baseline demographics will be collected, including gender, age, diagnosis, QMLT ultrasound measurement, subjective global assessment (SGA) malnutrition risk, pediatric z-scores, and activity levels. Investigators will assess the subjects' nutritional intake, body composition via QMLT ultrasound, mid-upper arm circumference, pediatric z-scores (weight, length, and body mass index), biomarkers (leptin, IL-6, Lipid profiles, Cystatin-C, Vitamin D, and C-reactive protein), compliance and tolerance to nutrition intervention, physical activity, and clinical outcomes (rates of infection, number of hospital days for non-chemotherapy administration, number of clinic visits for non-chemotherapy administration, chemotherapy toxicity CTCAE grade, rate or relapse, and 1-year survival rates) at multiple time points throughout the study. Nutritional assessment will involve a 24-hour food recall which will be performed at diagnosis, randomization, and then every 1-2 weeks once randomized to an intervention. Weight loss and pediatric z-scores (weight-for-age, length-for-age, and BMI-for-age) will be assessed every 1-2 weeks throughout the study enrollment. Ultrasound assessment will be of the QMLT by measuring at the midpoint between the ASIS and the upper pole of the patella. The measurements will be taken bilaterally, three times, and averaged together for the final measurement. Ultrasound assessment will occur at enrollment when weight loss criteria are met for randomization, and then at 1 month and 3 months after randomization (or when the weight lost is regained).

Pediatric physical activity will be assessed every 1-2 weeks in combination with ultrasound measurements. Adherence and adverse effects to medications, tube feeds, or oral nutrition supplements will be assessed at each clinic visit. Biomarkers will be analyzed at randomization, 1 month, and 3 months after randomization. Standard of care for patients are to receive MNT education at diagnosis. For those that lose weight, standard of care is to receive the nutrition interventions listed above (oral nutrition supplements, appetite stimulants, or enteral nutrition via feeding tube). The standard of care is to generally go from a least invasive to a more invasive approach. The research components of this study include being randomized to a nutrition intervention rather than a non-validated step-wise approach, the ultrasound measurements, and the biomarkers. These components are not considered standard of care and are research procedures. Baseline demographics will be collected, including gender, age, diagnosis, QMLT ultrasound measurement, subjective global assessment (SGA) malnutrition risk, pediatric z-scores, and activity levels. The team will assess the subjects' nutritional intake, body composition via QMLT ultrasound, mid-upper arm circumference, pediatric z-scores (weight, length, and body mass index), biomarkers (leptin, IL-6, Lipid profiles, Cystatin-C, Vitamin D, and C-reactive protein), compliance and tolerance to nutrition intervention, physical activity, and clinical outcomes (rates of infection, number of hospital days for non-chemotherapy administration, number of clinic visits for non-chemotherapy administration, chemotherapy toxicity CTCAE grade, rate or relapse, and 1-year survival rates) at multiple timepoints throughout the study. Nutritional assessment will involve a 24-hour food recall which will be performed at diagnosis, randomization, and then every 1-2 weeks once randomized to an intervention. Weight loss and pediatric z-scores (weight-for-age, length-for-age, and BMI-for-age) will be assessed every 1-2 weeks throughout the study enrollment. Ultrasound assessment will be of the QMLT by measuring at the midpoint between the ASIS and the upper pole of the patella, a total of 4 ultrasounds will be conducted during the study. The measurements will be taken bilaterally, three times, and averaged together for the final measurement. Ultrasound assessment will occur at enrollment when weight loss criteria are met for randomization, and then every 1-2 weeks for up to 8 weeks after randomization. Pediatric physical activity will be assessed every 1-2 weeks in combination with ultrasound measurements. Adherence and adverse effects to medications, tube feeds, or oral nutrition supplements will be assessed at each clinic visit.

Biomarkers will be analyzed at randomization, and weeks 4 and 8 after randomization. Additionally, measurements of resource utilization will be measured such as the number of hospital days for non-chemotherapy-related problems, the number of sick visits to the clinic, dietitian visits, infections, and rates of relapse or overall survival. Biomarkers will be drawn when the children are in the clinic for chemotherapy or lab work. The participants will already have their central venous line accessed by a qualified clinic RN and labs will be drawn at that time to ensure no extra harm to the patient. Additionally, all patients will have EMLA cream used to numb the area prior to having a clinic RN who is trained in accessing ports and has accessed the ports during previous clinic visits and will continue to do so throughout therapy.

Pediatric Oncology Nutrition Intervention Trial

The Pediatric Oncology Interventional Nutrition Therapy (POINT) Trial: A Pilot Study

Change in body composition will be measured by ultrasound of the quadricep muscle layer thickness in millimeters.

Change in body composition will be measured by mid-upper arm circumference via z-scores by measuring the mid-upper arm in centimeters and comparing to CDC standards.

These will be measured by CTCAEs to determine grade toxicity from interventions.

This will be measured with weight in kilograms and will be combined with data from CDC standardized growth charts to provide the weight z-score.

This will be measured with pediatric z-scores for BMI and weight/length z-scores. Weight in kilograms and height in cm will be combined to report BMI in kg/m\^2 and then plotted on CDC growth charts for z-scores.

These biomarkers will be measured via central venous lines, including IL-6 (pg/mL)

These biomarkers will be measured via central venous lines, including leptin (ng/mL) and vitamin D (ng/mL).

These biomarkers will be measured via central venous lines, including lipid profile (mg/dL).

These biomarkers will be measured via central venous lines, including cystatin-c (mg/L) and CRP (mg/L).

Physical activity will be measured by team assessment of Lanksy Play-Performance Scale for Pediatric Functional Status. This scale uses parent descriptions of child's activity to assess ability and response to treatment. Scale ranges from 0-100 with a higher score indicating greater activity.

Compliance will be analyzed by self-reported weekly compliance tube feeding volume which will be measured by the change in volume in mL compared to prescribed amounts in mL.

Compliance will be analyzed by self-reported weekly compliance oral nutrition supplements which will be measured by the change in volume in number of cans compared to prescribed amounts in number of cans.

Compliance will be analyzed by self-reported weekly compliance of medication consumption which will be measured by the change in days all prescribed medications were taken compared to days where less medications than prescribed were taken.

These measurements will include the number of days hospitalized for nutrition-related issues

These measurements will include the number of clinic visits for nutrition-related issues

These measurements will include if they have a diagnosis of malnutrition (yes/no).

These measurements will include the rate of relapse or progression (yes/no)

These measurements will include the number of days that cancer treatment is put on hold.

These measurements will include the presence of chemotherapy toxicities using CTCAE (Common Terminology Criteria for Adverse Events) grading scale (grades 1-4)

These measurements will include the diagnosis type (cancer type).

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Effect of NUTRICAN to Improve Nutritional Status in Cancer Patients	NCT06128694	Malnutrition; P... Cancer, Lung Cancer Cervix	NUTRICAN	18 Years -	Kalbe International Pte. Ltd
Effect of Postoperative Family Nutrition Mode on Weight/BMI of Patients With Esophageal Cancer	NCT03286920	Esophageal Canc...	Oral nutrition ... Tube feeding nu...	- 80 Years	Peking University Cancer Hospital & Institute
Pediatric Oncology Nutrition Intervention Trial	NCT06175273	Pediatric Cance... Nutrition Relat... Nutrition Aspec... Muscle Loss Malnutrition, C...	Oral Nutrition ... Tube Feed Cyproheptadine Dronabinol Standard of Car...	2 Years - 19 Years	University of Kentucky

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