title: Muscle wasting as main evidence of energy impairment in cancer cachexia: future therapeutic approaches.
abstract: The present review aimed at discussing the impact, pathogenesis and therapeutic approaches of muscle wasting, which is a major clinical feature of cancer-related cachexia syndrome. The pathogenesis of muscle wasting in cancer cachexia lies in a discrepancy between anabolic and catabolic pathways mediated by chronic inflammation. Effective interventions specifically aimed at hampering muscle loss and enhancing muscle function are still lacking. Promising agents include anti-inflammatory, orexigenic and anabolic drugs, alongside with nutritional supplements that influence the STAT3 and PI3K/Akt/mTOR pathways involved in muscle wasting. Personalized physical activity combined with pharmacological and nutritional support hold promise. A greater understanding of the pathogenetic processes of cancer cachexia-related muscle wasting will enable the development of an early and effective targeted mechanism-based multimodal approach.
authors.affiliation: Department of Medical Sciences M Aresu, AOU Cagliari, University of Cagliari, Italy.
authors.forename: Clelia
authors.initials: C
authors.lastname: Madeddu
authors.affiliation: Department of Medical Sciences M Aresu, AOU Cagliari, University of Cagliari, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mantovani
authors.affiliation: Medical Oncology Unit, NS Bonaria Hospital, San Gavino, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Gramignano
authors.affiliation: Department of Medical Sciences M Aresu, AOU Cagliari, University of Cagliari, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Astara
authors.affiliation: Department of Gynecologic Oncology, A Businco Hospital, Regional Referral Center for Cancer Diseases, Cagliari, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Macciò
keywords: IL-6; advanced cancer; cachexia; inflammation; mTOR; muscle wasting; quality of life