Background: Extracellular adenosine 5'-triphosphate (ATP) is involved in the regulation of a variety of biologic processes, including neurotransmission, muscle contraction, and liver glucose metabolism, via purinergic receptors, In nonrandomized studies involving patients with different tumor types including non-small-cell lung cancer (NSCLC), ATP infusion appeared to inhibit loss of weight and deterioration of quality of life (QOL) and performance status. We conducted a randomized clinical trial to evaluate the effects of ATP in patients with advanced NSCLC (stage IIIB or IV). Methods: Fifty-eight patients were randomly assigned to receive either 10 intravenous 30-hour ATP infusions, with the infusions given at 2- to 4-week intervals, or no ATP, Outcome parameters were assessed every 4 weeks until 28 weeks. Between-group differences were tested for statistical significance by use of repeated-measures analysis, and reported P values are two-sided. Results: Twenty-eight patients were allocated to receive ATP treatment and 30 received no ATP, Mean weight changes per 4-week period were -1.0 kg (95% confidence interval [CI] = -1.5 to -0.5) in the control group and 0.2 kg (95% CI = -0.2 to +0.6) in the ATP group (P = .002). Serum albumin concentration declined by -1.2 g/L (95% CI = -2.0 to -0.4) per 4 weeks in the control group but remained stable (0.0 g/L; 95% CI = -0.3 to +0.3) in the ATP group (P = .006). Elbow flexor muscle strength declined by -5.5% (95% CI = -9.6% to -1.4%) per 4 weeks in the control group but remained stable (0.0%; 95% CI = -1.4% to +1.4%) in the ATP group (P = .01). A similar pattern was observed far knee extensor muscles (P = .02). The effects of ATP on body weight, muscle strength, and albumin concentration were especially marked in cachectic patients (P = .0002, P = .0001, and P = .0001, respectively, for ATP versus no ATP). QOL score changes per 4-week period in the ATP group showed overall less deterioration than in the control group-physical scores (-0.2% versus -2.4%; P = .0002); functional scores (+0.4% versus -5.5%; P = .02); psychologic scores (-0.7% versus -2.4%; P = .11); overall QOL score (+0.1% versus -3.5%; P = .0001). Conclusions: This randomized trial demonstrates that ATP has beneficial effects on weight, muscle strength, and QOL in patients with advanced NSCLC.
Agteresch, H. J., Dagnelie, P. C., van der Gaast, A., Stijnen, T., & Wilson, J. H. P. (2000). Randomized clinical trial of adenosine 5'-triphosphate in patients with advanced non-small-cell lung cancer. Journal of the National Cancer Institute, 92, 321-328. https://doi.org/10.1093/jnci/92.4.321