Clinical Studies on the Treatment of Cancer Cachexia with Megestrol Acetate plus Thalidomide

Wen, Hongsheng; Li, Xu; Cao, Yu-zhu; Zhang, Cui-Cui; Yang, Fang; Shi, Yu-Ming; Peng, Liming

doi:10.1159/000346446

Cited by 63 publications

(45 citation statements)

References 26 publications

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“…Previous studies have shown beneficial results in humans with cancer cachexia using appetite stimulants such as megestrol acetate (with or without thalidomide, formoterol, and L‐carnitin) to improve skeletal muscle mass and strength . Beginning in 1993, megestrol acetate was approved in the USA and in several European countries for the treatment of the anorexia–cachexia syndrome .…”

Section: Therapeutic Strategies For Cardiac Cachexiamentioning

confidence: 99%

Cardiac cachexia: hic et nunc

Loncar

Springer

Anker

et al. 2016

J cachexia sarcopenia muscle

102

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Cardiac cachexia (CC) is the clinical entity at the end of the chronic natural course of heart failure (HF). Despite the efforts, even the most recent definition of cardiac cachexia has been challenged, more precisely, the addition of new criteria on top of obligatory weight loss. The pathophysiology of CC is complex and multifactorial. A better understanding of pathophysiological pathways in body wasting will contribute to establish potentially novel treatment strategies. The complex biochemical network related with CC and HF pathophysiology underlines that a single biomarker cannot reflect all of the features of the disease. Biomarkers that could pick up the changes in body composition before they convey into clinical manifestations of CC would be of great importance. The development of preventive and therapeutic strategies against cachexia, sarcopenia, and wasting disorders is perceived as an urgent need by healthcare professionals. The treatment of body wasting remains an unresolved challenge to this day. As CC is a multifactorial disorder, it is unlikely that any single agent will be completely effective in treating this condition. Among all investigated therapeutic strategies, aerobic exercise training in HF patients is the most proved to counteract skeletal muscle wasting and is recommended by treatment guidelines for HF.

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Section: Therapeutic Strategies For Cardiac Cachexiamentioning

confidence: 99%

Cardiac cachexia: hic et nunc

Loncar

Springer

Anker

et al. 2016

J cachexia sarcopenia muscle

102

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“…[102] Megesterol carries an increased risk of thromboembolism, while thalidomide is known to cause birth defects in pregnant patients.…”

Section: 4 Current and Potential Pharmacologic Therapies For Cimwmentioning

confidence: 99%

Bone Pain and Muscle Weakness in Cancer Patients

Milgrom

Lad

Koniaris

et al. 2017

Curr Osteoporos Rep

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Purpose of review In this article we will discuss the current understanding of bone pain and muscle weakness in cancer patients. We will describe the underlying physiology and mechanisms of cancer-induced bone pain (CIBP) and cancier-induced muscle wasting (CIMW), as well as current methods of diagnosis and treatment. We will discuss future therapies and research directions to help patients with these problems. Recent Findings There are several pharmacologic therapies that are currenly in pre-clinical and clinical testing that appear to be promising adjuncts to current CIBP and CIMW therapies. Such therapies include resiniferitoxin, which is a targeted inhibitor of nociptive nerve fibers, and selective androgen receptor modulators, which show promise in increasing lean mass. Summary CIBP and CIMW are a significant causes of morbidity in affected patients. Current management is mostly palliative; however, targeted therapies are poised to revolutionize how these problems are treated.

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“…Clinical trials with drugs such as ghrelin, and thalidomide combined with megasterol acetate do not directly target IL-6, but have demonstrated promise by attenuating some cachectic symptoms in cancer patients, such as appetite, weight gain and a feeling of well-being [50-52]. However, these therapies have the potential to indirectly suppress systemic IL-6 levels or muscle IL-6 production [51, 53]. Recent targeted human therapies for cachexia related to IL-6 have been focused on developing humanized antibodies that could rescue cachexia symptoms.…”

Section: L-6 Targeted Therapeutics: Clinical Studiesmentioning

confidence: 99%

Role of interleukin-6 in cachexia

Narsale¹,

Carson²

2014

Current Opinion in Supportive &Amp; Palliative Care

169

133

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Purpose of review Interleukin-6 (IL-6) has emerged as a cytokine involved in cachexia progression with some cancers. This review will present recent breakthroughs in animal models and humans related to targeting IL-6 as a cancer cachexia therapy. Recent Findings IL-6 can target adipose, skeletal muscle, gut, and liver tissue, which can all affect cachectic patient recovery. IL-6 trans-signaling through the soluble IL-6r has the potential to amplify IL-6 signaling in the cachectic patient. In skeletal muscle chronic IL-6 exposure induces proteasome and autophagy protein degradation pathways that lead to wasting. IL-6 is also indirectly associated with AMPK and NF-κB activation. Several mouse cancer models have clearly demonstrated that blocking IL-6 and associated signaling can attenuate cachexia progression. Additionally, pharmaceuticals targeting IL-6 and associated signaling can relieve some cachectic symptoms in cancer patients. Research with cachectic mice has demonstrated that exercise and nutraceutical administration can interact with chronic IL-6 signaling during cachexia progression. Summary IL-6 remains a promising therapeutic strategy for attenuating cachexia progression with many types of cancer. However, improvement of this treatment will require a better understanding of the indirect and direct effects of IL-6 as well as its tissue specific actions in the cancer patient.

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Clinical Studies on the Treatment of Cancer Cachexia with Megestrol Acetate plus Thalidomide

Cited by 63 publications

References 26 publications

Cardiac cachexia: hic et nunc

Cardiac cachexia: hic et nunc

Bone Pain and Muscle Weakness in Cancer Patients

Role of interleukin-6 in cachexia

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