Current pharmacotherapy options for cancer anorexia and cachexia.
BACKGROUND
Anorexia and cachexia syndrome represents a complex clinical picture that occurs in the late stage of several chronic inflammatory diseases, including cancer. Unless counteracted cancer-related anorexia and cachexia syndrome affects quality of life (QL) and survival. However, to date a standard effective treatment is lacking.


METHODS
The aim of this review is to describe the current pharmacological approaches for anorexia and cachexia syndrome, focusing on cancer-related syndrome. The several pharmacological agents tested so far are discussed, distinguishing them in unproven drugs, effective drugs, and drugs under investigation. Moreover, a section is devoted to the promising use of nutritional supplements and nutraceuticals. The emerging role of a multitargeted combined treatment approach is exhaustively reviewed.


CONCLUSIONS
Considering the complex clinical picture and the multifactorial pathogenesis of anorexia and cachexia syndrome, we believe that its clinical management requires a multidisciplinary and multipharmacological approach. In our opinion the anorexia and cachexia syndrome treatment should include drugs that target the following conditions: inflammatory status, oxidative stress, nutritional disorders, muscle catabolism, anemia, immunosuppression, and fatigue. The multidimensional therapies for anorexia and cachexia syndrome should ideally be introduced within a context of the "best supportive care," which includes optimal symptom management and careful psychosocial counseling.
Sirai Hospital, Department of Obstetrics and Gynecology, Carbonia, Italy. a.maccio@tin.it
Antonio
A
Macciò
Clelia
C
Madeddu
Giovanni
G
Mantovani
D000818:Animals; D000855:Anorexia / Q000188:drug therapy* / Q000209:etiology; D002100:Cachexia / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D011788:Quality of Life; D013577:Syndrome