title: Cancer cachexia update in head and neck cancer: Pathophysiology and treatment.
abstract: The pathophysiology of cancer cachexia remains complex. A comprehensive literature search was performed up to April 2013 using PubMed, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and the Google search engine. In this review, we focus on the different mediators of impaired anabolism and upregulated catabolism that alter the skeletal muscle homeostasis resulting in the wasting of cancer cachexia. We present recent evidence of targeted treatment modalities from clinical trials along with their potential mechanisms of action. We also report on the most current evidence from randomized clinical trials using multimodal treatments in patients with cancer cachexia, but also the evidence from head and neck cancer-specific trials. A more complete understanding of the pathophysiology of the syndrome may lead to more effective targeted therapies and improved outcomes for patients.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Vermont Cancer Center, University of Vermont, College of Medicine, Burlington, Vermont.
authors.forename: Marion E
authors.initials: ME
authors.lastname: Couch
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Vermont Cancer Center, University of Vermont, College of Medicine, Burlington, Vermont.
authors.forename: Kim
authors.initials: K
authors.lastname: Dittus
authors.affiliation: Department of Molecular Physiology and Biophysics, University of Vermont, College of Medicine, Burlington, Vermont.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Toth
authors.affiliation: Department of Pathology and Laboratory Medicine, McAllister Heart Institute, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Monte S
authors.initials: MS
authors.lastname: Willis
authors.affiliation: Department of Molecular Virology, Immunology, and Medical Genetics, Ohio State University, Columbus, Ohio.
authors.forename: Denis C
authors.initials: DC
authors.lastname: Guttridge
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, California.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: George
authors.affiliation: University of Vermont, College of Medicine, Burlington, Vermont.
authors.forename: Eric Y
authors.initials: EY
authors.lastname: Chang
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Christine G
authors.initials: CG
authors.lastname: Gourin
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Vermont Cancer Center, University of Vermont, College of Medicine, Burlington, Vermont.
authors.forename: Hirak
authors.initials: H
authors.lastname: Der-Torossian
mesh_terms: D002100:Cachexia / Q000503:physiopathology* / Q000628:therapy; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000503:physiopathology* / Q000628:therapy; D006801:Humans
keywords: cancer cachexia and anorexia; clinical trials; head and neck cancer; multimodal treatment; pathophysiology