On our way to targeted therapy for cachexia in cancer?
OBJECTIVE
Cachexia, the occurrence of involuntary weight loss due to loss of adipose tissue and skeletal muscle mass, is among the most common and devastating symptoms in patients with advanced cancer. It is a significant factor contributing to the poor performance status and high mortality rate of these patients, and is a distressing problem for both patients and their families. Despite extensive research in an attempt to better understand the mechanisms involved, progress in the management of cancer cachexia has been slow.


RESULTS
The pathogenic mechanisms of cachexia and anorexia are multifactorial, but cytokines and tumour-derived factors are known to play a significant role, thereby representing suitable therapeutic targets. Moreover, recent advances in the field of molecular biology have shed light on other mediators involved in the mechanisms leading to muscle wasting, thus increasing potential targets for new therapies.


CONCLUSIONS
This review will focus on recent findings in relation to the molecular pathways leading to muscle wasting that have improved our current understanding of cachexia and will direct the future management of cachexia in cancer towards targeted therapies.
Boddaert
Manon S A
MS
Department of Medical Oncology, VUMC Cancer Center Amsterdam, Amsterdam, The Netherlands. msa.boddaert@Vumc.nl
Gerritsen
Winald R
WR
Pinedo
Herbert M
HM
D000970:Antineoplastic Agents / Q000494:pharmacology; D001067:Appetite Depressants / Q000494:pharmacology; D002100:Cachexia / Q000209:etiology / Q000628:therapy*; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D018482:Muscle, Skeletal / Q000473:pathology; D009133:Muscular Atrophy / Q000628:therapy; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*
D000970:Antineoplastic Agents; D001067:Appetite Depressants; D016207:Cytokines