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This oral nutritional supplement (ONS) is a protein- and energy-dense formulation enriched with eicosapentaenoic acid (EPA), an omega-3 polyunsaturated fatty acid. Developed and evaluated in clinical trials by Charite University, Berlin, it is primarily indicated for the management of malnutrition and cancer cachexia in patients with gastrointestinal tumors, including colorectal, hepatocellular, and cholangiocarcinoma. EPA acts as an anti-catabolic and anti-inflammatory agent by modulating the systemic inflammatory response. It competes with arachidonic acid for cyclooxygenase (COX) and lipoxygenase (LOX) enzymes, thereby reducing the production of pro-inflammatory 2-series prostaglandins and 4-series leukotrienes, which are associated with muscle wasting and weight loss in malignant diseases.
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