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There was no change in plasma phospholipids EPA or DHA from baseline to end of trial in the SOC group (Table 2). After supplementation, plasma EPA and DHA in the FO group were significantly higher than the SOC group (P http://www.selleckchem.com/products/17-AAG(Geldanamycin).html clinical benefit were approximately 2-fold greater in the FO group compared with the SOC group (Table 3). The proportion of patients in the FO and SOC group who had a CR, SD, PR, or PD is shown in Table 3. Logistic regression demonstrated that plasma phospholipid EPA concentration after supplementation was a significant predictor of response to chemotherapy independent of age, sex, BMI, presence of sarcopenia, performance score, and weight loss history (hazard ratio [HR], 1.8; 95% CI, 1.1 to 2.5; P = .03). There were no other significant predictors of response to treatment. Compared with the FO group, a greater percentage of patients in the SOC group had progressive disease after 2 cycles of chemotherapy. Consequently, more patients in the FO group completed all planned chemotherapy (86.7% vs 54.8%, P = .03). On average, patients in the FO group completed an additional 3 weeks of chemotherapy (1 cycle) compared with patients in the SOC group (Table 3). Despite the wide variation in overall survival (1-30 months), 1-year survival in the FO group appeared to be greater than in the SOC group (Table 3). The median number of post-trial lines of therapy was 1 in both cohorts. The most common post-trial therapy was http://www.selleck.cn/products/VX-809.html erlotinib (55% of SOC and 53% of FO group). Thirty-five percent of patients in the SOC group and 27% patients in the FO did not receive any further treatment (P = .40). FO supplementation was well-tolerated with no reported adverse events. The most commonly reported chemotherapy-related grade 1 and 2 toxicities were neutropenia followed by nausea, vomiting, and http://www.selleckchem.com/products/lgk-974.html thrombocytopenia. The overall incidence of any grade 3 or 4 toxicity was 22.6% in the SOC group versus 13.3% in the FO group (P = .46). Grades 3 and 4 toxicities included nausea, vomiting, hand-foot syndrome, neutropenia, constipation, and gastritis. One patient in each group discontinued treatment because of fatigue and increased symptom burden. Hematological toxicity resulted in treatment discontinuation in 2 patients in the SOC group. In the SOC group, a further 2 patients discontinued chemotherapy because of gastritis and hand-foot syndrome. The total incidence of grade 3 or 4 toxicity resulting in discontinuation of planned chemotherapy did not differ between groups (16.1% vs 6.7%, P = .52). Logistic regression did not reveal any significant predictors of grade 3 or 4 toxicity. The goal of palliative chemotherapy is to improve symptoms and survival. However, more than 65% of advanced NSCLC cases do not respond to first-line chemotherapy,2-4 and 1-year survival rates are low. This is the first study to show that the addition of approximately 2.