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New drugs for the anorexia-cachexia syndrome
1The Harry R. Horvitz Center for Palliative Medicine, Taussig Cancer Center, The Cleveland Clinic Foundation, R35, 9500 Euclid Avenue, Cleveland, OH 44195, USA. davism@ccf.org
Current Oncology Reports
|April 9, 2002
Summary
Cancer-associated anorexia and cachexia are distinct metabolic conditions causing significant mortality. Effective treatment involves reducing energy expenditure and reversing metabolic abnormalities, potentially with new biologic agents.
Area of Science:
- Oncology
- Metabolic Medicine
- Pharmacology
Background:
- Anorexia and cachexia are prevalent and fatal symptoms in advanced cancer, distinct from starvation.
- Cachexia contributes to 22% of cancer-related deaths due to unique pathophysiology.
- Key factors include elevated resting energy expenditure and abnormal metabolism independent of intake.
Purpose of the Study:
- To review the pathophysiology of cancer anorexia and cachexia.
- To discuss treatment strategies including appetite stimulants and biologic agents.
- To evaluate the antitumor and anticachectic activities of novel drugs.
Main Methods:
- Review of existing literature on cancer cachexia pathophysiology and treatment.
- Analysis of data from animal tumor models for biologic agents.
- Assessment of in vivo and in vitro antitumor activity of anticachectic drugs.
Main Results:
- Cachexia involves complex interactions of catecholamines, prostaglandins, and inflammatory cytokines.
- Successful management requires addressing energy expenditure, anorexia, and metabolic dysregulation.
- Several anticachectic agents show promising antitumor effects in preclinical studies.
Conclusions:
- Cancer cachexia is a complex syndrome requiring multifaceted treatment approaches.
- Combination therapies with appetite stimulants and novel biologic agents show potential.
- Some anticachectic drugs possess intrinsic antitumor activity, warranting further investigation.