Effects of Multicomponent Interventions for Adults With Cancer Cachexia on Physical Function Outcomes

ABSTRACT Introduction Progressive functional decline is a defining feature of cancer cachexia. We evaluated the effects of multicomponent interventions for adults with cancer cachexia on physical function outcomes. We also explored whether changes in physical function outcomes or overall quality of life varied following interventions with or without components directly targeting physical function (e.g., exercise training). Methods We analysed functional outcomes from studies included in our published systematic review of multicomponent interventions for adults with cancer cachexia, supplemented with an updated search. We conducted meta‐analyses of change scores from randomised trials comparing physical function outcomes following multicomponent interventions versus standard care. Exploratory analyses of standardised effect measures, including studies of any design, compared interventions based on whether or not they directly targeted physical function. Results We analysed data from 35 studies of multicomponent interventions, 19 of which included components directly targeting physical function. Handgrip strength was on average 1.06 kg greater (95% CI, −0.72–2.84 kg), and 6‐min walk distance was on average 16.20 m greater (95% CI, −38.27–70.67 m), following multicomponent intervention compared with standard care. Exploratory analysis showed improvement in fatigue was highest following an intervention with a specific fatigue self‐management component (standardised mean change: 4.76). Standardised mean change in quality of life was slightly lower following interventions with components directly targeting physical function (0.28 vs. 0.59) though effects were varied. Conclusions Multicomponent interventions appear to be superior to standard care for improving some measures of physical function for adults with cancer cachexia, namely, handgrip strength and the 6‐min walk distance. Interventions targeting specific aspects of physical function (e.g., fatigue) may lead to greater improvements in those outcomes.