Revisiting Cancer Cachexia: Pathogenesis, Diagnosis, and Current Treatment Approaches

Baba, Mudasir Rashid; Buch, Sajad Ahmad

doi:10.4103/apjon.apjon-2126

Cited by 20 publications

(21 citation statements)

References 120 publications

(130 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The best treatment for cancer cachexia depends on the disease stage ( 29 ), because, before developing into refractory cachexia, the patient’s condition can be reversed through the use of effective drugs ( 30 ), nutritional support ( 31 ), exercise ( 32 ), and psychosocial support ( 33 ). Therefore, it is extremely important to identify, monitor, and treat cancer cachexia at the earliest; hence our research is of great significance.…”

Section: Discussionmentioning

confidence: 99%

Novel Diagnostic and Prognostic Tools for Lung Cancer Cachexia: Based on Nutritional and Inflammatory Status

et al. 2022

View full text Add to dashboard Cite

BackgroundCachexia is one of the most common complications affecting lung cancer patients that seriously affects their quality-of-life and survival time. This study aimed to analyze the predictors and prognostic factors of lung cancer cachexia as well as to develop a convenient and accurate clinical prediction tool for oncologists.MethodsIn this multicenter cohort study, 4022 patients with lung cancer were retrospectively analyzed. The patients were randomly categorized into training and verification sets (7:3 ratio). Univariate and multivariate logistic regression analyses were performed to determine the risk factors of cachexia in patients with lung cancer. Cox regression analysis was applied to determine independent prognostic factors in the patients with lung cancer cachexia. Meanwhile, two nomograms were established and evaluated by time-dependent receiver operating characteristic curve, calibration curve, and decision curve analysis (DCA).ResultsStage, serum albumin, ALI, anemia, and surgery were independent risk factors for cachexia in patients with lung cancer. Patients with lung cancer cachexia have a shorter survival time. Sex, stage, serum albumin, ALI, KPS score, and surgery served as independent prognostic factors for patients with lung cancer cachexia. The area under the curves (AUCs) of diagnostic nomogram in the training and validation sets were 0.702 and 0.688, respectively, the AUCs of prognostic nomogram in the training set for 1-, 3-, and 5-year were 0.70, 0.72, and 0.75, respectively, while in the validation set the AUCs were 0.71, 0.75, and 0.79, respectively. The calibration curves and DCA of the two nomograms were consistent and the clinical benefit rate was high.ConclusionCachexia brings an additional economic burden and worsens the prognosis of lung cancer patients. The two nomograms can accurately screen and predict the probability of occurrence of cachexia in lung cancer and the prognosis of patients with lung cancer cachexia, and guide clinical work.

show abstract

Section: Discussionmentioning

confidence: 99%

Novel Diagnostic and Prognostic Tools for Lung Cancer Cachexia: Based on Nutritional and Inflammatory Status

et al. 2022

View full text Add to dashboard Cite

show abstract

“…223 For effective anabolic resistance, an increase in caloric intake of 300-400 kcal/day and 50% extra protein intake is essential. 224 High calorie and proteinaceous diet along with oral supplementation of β-hydroxy-β-methyl butyrate (HMB), omega-3 fatty acids, L-carnitine, and eicosatetraenoic acid have shown to be beneficial in patients with CPC and CC. [225][226][227][228][229] A study conducted on lung cancer patients showed that oral administration of omega-3 fatty acids increases lean body mass and improves the cachectic conditions in these patients.…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

“…230 In addition, pharmacological agents such as those that target proinflammatory cytokines, non-steroidal anti-inflammatory drugs (NSAIDs), and cannabinoids have been widely used to treat CC. 224 Anti-TNFα agents such as etanercept and infliximab, thalidomide, and pentoxifylline showed a modest gain in lean body mass with no noteworthy clinical benefits. 15,16,[231][232][233][234][235] Clazakizumab humanized anti-IL-6 monoclonal antibody increased the hemoglobin and ALB levels and relieved fatigue in advancedstage cancer patients.…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Tumor cell anabolism and host tissue catabolism-energetic inefficiency during cancer cachexia

Hegde

Daimary

Girisa

et al. 2022

Exp Biol Med (Maywood)

View full text Add to dashboard Cite

Cancer-associated cachexia (CC) is a pathological condition characterized by sarcopenia, adipose tissue depletion, and progressive weight loss. CC is driven by multiple factors such as anorexia, excessive catabolism, elevated energy expenditure by growing tumor mass, and inflammatory mediators released by cancer cells and surrounding tissues. In addition, endocrine system, systemic metabolism, and central nervous system (CNS) perturbations in combination with cachexia mediators elicit exponential elevation in catabolism and reduced anabolism in skeletal muscle, adipose tissue, and cardiac muscle. At the molecular level, mechanisms of CC include inflammation, reduced protein synthesis, and lipogenesis, elevated proteolysis and lipolysis along with aggravated toxicity and complications of chemotherapy. Furthermore, CC is remarkably associated with intolerance to anti-neoplastic therapy, poor prognosis, and increased mortality with no established standard therapy. In this context, we discuss the spatio-temporal changes occurring in the various stages of CC and highlight the imbalance of host metabolism. We provide how multiple factors such as proteasomal pathways, inflammatory mediators, lipid and protein catabolism, glucocorticoids, and in-depth mechanisms of interplay between inflammatory molecules and CNS can trigger and amplify the cachectic processes. Finally, we highlight current diagnostic approaches and promising therapeutic interventions for CC.

show abstract

“…The presence of this finding at the time of detection of non-small cell lung cancer (NSCLC) portends poor survival, even after controlling for other factors such as age, sex, comorbidity, and tumor stage (21)(22)(23). Although targeted interventions are currently limited (24)(25)(26), evidence highlighting the benefits of nutritional rehabilitation for weightlosing cancer patients continues to emerge (27)(28)(29)(30). Therefore, early identification of patients bearing tumors with metabolic ramifications is essential.…”

Section: Introductionmentioning

confidence: 99%

Primary Tumor Fluorine‐18 Fluorodeoxydglucose (18F‐FDG) Is Associated With Cancer-Associated Weight Loss in Non-Small Cell Lung Cancer (NSCLC) and Portends Worse Survival

et al. 2022

View full text Add to dashboard Cite

AimTo investigate the diagnostic potential of and associations between tumor 18F‐FDG uptake on PET imaging and cancer-associated weight loss.Methods774 non-small cell lung cancer (NSCLC) patients with pre-treatment PET evaluated between 2006 and 2014 were identified. Using the international validated definition of cachexia, the presence of clinically significant pretreatment cancer-associated weight loss (WL) was retrospectively determined. Maximum Standardized Uptake Value (SUVMax) of 18F‐FDG was recorded and dichotomized based on 3 experimental cutpoints for survival analyses. Each SUVMax cutpoint prioritized either survival differences, total cohort comparison sample sizes, or sample size by stage. Patient outcomes and associations between SUVMax and cancer-associated weight loss were assessed by multivariate, categorical, and survival analyses.ResultsPatients were found to have an increased likelihood of having WL at diagnosis associated with increasing primary tumor SUVMax after controlling for potentially confounding patient and tumor characteristics on multivariate logistic regression (OR 1.038; 95% CI: 1.012, 1.064; P=0.0037). After stratifying the cohort by WL and dichotomized SUVMax, both factors were found to be relevant in predicting survival outcomes when the alternative variable was constant. Of note, the most striking survival differences contributed by WL status occurred in high SUVMax groups, where the presence of WL predicted a median survival time detriment of up to 10 months, significant regardless of cutpoint determination method applied to categorize high SUVMax patients. SUVMax classification was found to be most consistently relevant in both WL and no WL groups.ConclusionsThe significant positive association between significant pretreatment cancer-associated weight loss and primary tumor SUVMax underscores increased glucose uptake as a component of catabolic tumor phenotypes. This substantiates 18F‐FDG PET analysis as a prospective tool for assessment of cancer-associated weight loss and corresponding survival outcomes. Furthermore, the survival differences observed between WL groups across multiple SUVMax classifications supports the importance of weight loss monitoring in oncologic workups. Weight loss in the setting of NSCLCs with higher metabolic activity as determined by 18F‐FDG PET signal should encourage more aggressive and earlier palliative care interventions.

show abstract

Revisiting Cancer Cachexia: Pathogenesis, Diagnosis, and Current Treatment Approaches

Cited by 20 publications

References 120 publications

Novel Diagnostic and Prognostic Tools for Lung Cancer Cachexia: Based on Nutritional and Inflammatory Status

Novel Diagnostic and Prognostic Tools for Lung Cancer Cachexia: Based on Nutritional and Inflammatory Status

Tumor cell anabolism and host tissue catabolism-energetic inefficiency during cancer cachexia

Primary Tumor Fluorine‐18 Fluorodeoxydglucose (18F‐FDG) Is Associated With Cancer-Associated Weight Loss in Non-Small Cell Lung Cancer (NSCLC) and Portends Worse Survival

Contact Info

Product

Resources

About