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Cancer cachexia, mechanism and treatment
#MMPMID25897346
Aoyagi T
; Terracina KP
; Raza A
; Matsubara H
; Takabe K
World J Gastrointest Oncol
2015[Apr]; 7
(4
): 17-29
PMID25897346
show ga
It is estimated that half of all patients with cancer eventually develop a
syndrome of cachexia, with anorexia and a progressive loss of adipose tissue and
skeletal muscle mass. Cancer cachexia is characterized by systemic inflammation,
negative protein and energy balance, and an involuntary loss of lean body mass.
It is an insidious syndrome that not only has a dramatic impact on patient
quality of life, but also is associated with poor responses to chemotherapy and
decreased survival. Cachexia is still largely an underestimated and untreated
condition, despite the fact that multiple mechanisms are reported to be involved
in its development, with a number of cytokines postulated to play a role in the
etiology of the persistent catabolic state. Existing therapies for cachexia,
including orexigenic appetite stimulants, focus on palliation of symptoms and
reduction of the distress of patients and families rather than prolongation of
life. Recent therapies for the cachectic syndrome involve a multidisciplinary
approach. Combination therapy with diet modification and/or exercise has been
added to novel pharmaceutical agents, such as Megestrol acetate,
medroxyprogesterone, ghrelin, omega-3-fatty acid among others. These agents are
reported to have improved survival rates as well as quality of life. In this
review, we will discuss the emerging understanding of the mechanisms of cancer
cachexia, the current treatment options including multidisciplinary combination
therapies, as well an update on new and ongoing clinical trials.
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