title: Evidence base for multimodal therapy in cachexia.
abstract: OBJECTIVE
  The lack of success of unimodal treatment studies in cachexia and the growing awareness that multiple components are responsible for the development of cachexia have led to the view that cachexia intervention should include multimodal treatment. The aim of this article is to examine the evidence for multimodal treatment in the management of cancer cachexia.
  
  
  RESULTS
  There are some studies involving multimodal treatment that indicate significant effects on cachexia outcomes. There are, however, no randomized controlled trials to date that incorporate fully a structured exercise program, nutrition, good symptom treatment as well as drug treatment, to counteract the effects of altered metabolism.
  
  
  CONCLUSIONS
  The effectiveness of any drug intervention for cancer cachexia probably will only be maximized if incorporated into multimodal treatment. Further, cachexia treatment trials should also aim to include patients at an early phase in their cachexia trajectory and use validated outcome measures.
authors.affiliation: Department of Cancer Research and Molecular Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology, Trondheim, Norway. tora.l.skeidsvoll@ntnu.no
authors.forename: Tora S
authors.initials: TS
authors.lastname: Solheim
authors.forename: Barry J A
authors.initials: BJ
authors.lastname: Laird
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002100:Cachexia / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods*; D004032:Diet; D019587:Dietary Supplements; D015444:Exercise; D006801:Humans; D009369:Neoplasms / Q000150:complications*
chemical_list: D000893:Anti-Inflammatory Agents