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Cancer cachexia,mechanism and treatment

Cancer cachexia,mechanism and treatment

作     者:Tomoyoshi Aoyagi Krista P Terracina Ali Raza Hisahiro Matsubara Kazuaki Takabe 

作者机构:Division of Surgical Oncology Department of SurgeryVirginia Commonwealth University School of Medicine and the Massey Cancer Center Department of Frontier Surgery Graduate School of Medicine Chiba University 

出 版 物:《World Journal of Gastrointestinal Oncology》 (世界胃肠肿瘤学杂志(英文版)(电子版))

年 卷 期:2015年第7卷第4期

页      面:17-29页

核心收录:

学科分类:1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基  金:Supported by NIH No.R01CA160688 and No.T32CA085159-10 

主  题:Physical exercise Pharmacological treatment Cancer cachexia 

摘      要: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 responsesto 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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