Clinical evaluation and optimal management of cancer cachexia.
Source
Department of Medical Oncology, Hospital Clinic Barcelona, Barcelona University, Barcelona, Spain. Electronic address: atuca@clinic.ub.es.
Abstract
Cancer anorexia-cachexia syndrome (CACS) is a complex metabolic syndrome, different from malnutrition and sarcopenia, which is very common in cancer patients. Treatment for CACS is based on nutritional support and CACS pathophysiology-modulating drugs. The most commonly used are megestrol acetate (MA) and corticosteroids. The efficacy of MA has been confirmed by multiple clinical trials and meta-analyses. Glucocorticoids are also effective but should only be used for short periods and in selected cases. Future strategies should include intensified research into potentially effective drugs (ω-3 fatty acids, thalidomide, cannabinoids, ghrelin, bortezomib, and COX-2 inhibitors), combined treatment and new drugs (anti-IL-6 monoclonal antibodies, melanocortin, β-2 antagonists, and androgen receptor-modulating analogues). We propose a review based on the literature on the pathophysiology of CACS, the diagnostic criteria and treatment, and future strategies.
Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
KEYWORDS:
Anorexia, Cachexia, Cancer, Malnutrition, Megestrol acetate
- PMID:
- 23953794
- [PubMed – as supplied by publisher]