Related Experiment Video
Updated: Dec 5, 2025

Author Spotlight: Advanced Integrated Model for Sepsis-Induced Myopathy and Single-Cell Metabolic Analysis
Published on: June 14, 2024
Skeletal Muscle Loss during Multikinase Inhibitors Therapy: Molecular Pathways, Clinical Implications, and
Emanuele Rinninella1, Marco Cintoni2, Pauline Raoul3
1UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
Abstract:
In cancer patients, loss of muscle mass is significantly associated with low tolerability of chemotherapy and poor survival. Despite the great strides in the treatment of cancer, targeted therapies such as tyrosine kinase inhibitors (TKIs) could exacerbate muscle wasting. Over recent years, the impact of skeletal muscle loss during TKI therapy on clinical outcomes has been in the spotlight. In this review, we focus on the different molecular pathways of TKIs potentially involved in muscle wasting. Then, we report the results of the studies assessing the effects of different TKI therapies-such as sorafenib, regorafenib, sunitinib, and lenvatinib-on muscle mass, and highlight their potential clinical implications. Finally, we discuss an integrative nutritional approach to be adopted during TKI treatment. The assessment of muscle mass from computerized tomography imaging could be helpful in predicting toxicity and prognosis in patients treated with TKI such as sorafenib. Early recognition of low muscle mass and effective personalized nutritional support could prevent or attenuate muscle mass wasting. However, the role of nutrition is still overlooked, and future clinical trials are needed to find the optimal nutritional support to countermeasure muscle mass depletion during TKI therapy.
Insights
Tyrosine kinase inhibitors (TKIs) used in cancer treatment can worsen muscle wasting, impacting patient survival. Early nutritional support and muscle mass assessment are crucial for managing this side effect.
Area of Science:
- Oncology
- Muscle Physiology
- Pharmacology
Background:
- Muscle wasting (sarcopenia) is linked to poor chemotherapy tolerance and survival in cancer patients.
- Tyrosine kinase inhibitors (TKIs), while advancing cancer treatment, can exacerbate muscle wasting.
- The clinical impact of skeletal muscle loss during TKI therapy is a growing concern.
Purpose of the Study:
- To review molecular pathways of TKIs implicated in muscle wasting.
- To analyze studies on TKI effects (sorafenib, regorafenib, sunitinib, lenvatinib) on muscle mass.
- To discuss nutritional strategies to mitigate TKI-induced muscle loss.
Main Methods:
- Literature review focusing on TKI mechanisms and clinical studies.
- Analysis of data on muscle mass changes in patients receiving specific TKIs.
- Synthesis of evidence on nutritional interventions for cancer patients on TKIs.
Main Results:
- TKIs may induce muscle wasting through various molecular pathways.
- Studies show sorafenib, regorafenib, sunitinib, and lenvatinib can affect muscle mass.
- Computerized tomography assessment of muscle mass can predict TKI toxicity and prognosis.
Conclusions:
- Early identification of low muscle mass and personalized nutrition are key to managing TKI-related muscle wasting.
- Nutritional support is often overlooked but vital during TKI therapy.
- Further clinical trials are needed to define optimal nutritional strategies against muscle depletion.
Related Concept Videos
Chronic Kidney Disease III: Interprofessional Care
Chronic Kidney Disease II: Clinical Manifestations
mTOR Signaling and Cancer Progression
The mTOR pathway or the...
PI3K/mTOR/AKT Signaling Pathway
Skeletal Muscle Relaxants: Adverse Effects
Unlike...
Disorders of the Skeletal Muscle
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...

