A Review of the Drug Treatment of Cachexia Associated with Cancer

  title={A Review of the Drug Treatment of Cachexia Associated with Cancer},
  author={Bruno Gagnon and Eduardo Bruera},
SummaryIn the past 20 years, cachexia in cancer patients has attracted increasing interest from both clinicians and basic researchers. It is now clear that the cachexia is secondary to major metabolic abnormalities due to tumour by-products and cytokine release. These metabolic abnormalities produce numerous symptoms such as cachexia, anorexia and asthenia.There are now effective drugs such as corticosteroids and progestational drugs that have been shown to improve appetite, food intake and… 
Cancer cachexia, mechanism and treatment.
The emerging understanding of the mechanisms of cancer cachexia, the current treatment options including multidisciplinary combination therapies, as well an update on new and ongoing clinical trials are discussed.
Managing Cancer-Related Anorexia/Cachexia
Work on the potential role of antioxidant agents in counteracting the oxidative stress, which appears to be involved in CAC, shows them to be promising agents when used in combination chemotherapy regimens either alone or with other ‘biologics’.
Cancer cachexia—pathophysiology and management
The best treatment of the cachectic syndrome is a multifactorial approach, and health care providers must also recognize the psychosocial and biomedical impact cachexia can have.
Appetite stimulants for patients with cancer: current evidence for clinical practice.
Currently, there is no current standard of care for patients with cancer-related anorexia, and international guidelines recommend promoting anabolism through nutritional, physical, and pharmacologic therapies.
The Science of Megestrol Acetate Delivery
Preclinical pharmacokinetic data suggest that the new megestrol acetate formulation has the potential to significantly shorten the time to clinical response and thus may improve outcomes in patients with anorexia-cachexia.
Integrative role of neuropeptides and cytokines in cancer anorexia-cachexia syndrome.
  • S. Patra, S. Arora
  • Medicine, Biology
    Clinica chimica acta; international journal of clinical chemistry
  • 2012
Cancer Cachexia Syndrome: Pathogenesis, Diagnosis, and New Therapeutic Options
There is a tendency toward an integrated multiple approach including nonpharmacological and pharmacological treatments, however, currently there is not enough evidence to support a change in clinical practice.
Efficacy and safety of Yukgunja-Tang for treating anorexia in patients with cancer
This study is the first randomized controlled trial to investigate the efficacy and the safety of using YGJT for treating patients with cancer-related anorexia in Korea and to establish whether or not it can be recommended as the primary therapy.
Potential Novel Uses of Thalidomide
Thalidomide therapy of diseases such as tuberculosis, sarcoidosis, aphthous ulcers in HIV syndrome and Behcet’s disease, rheumatoid arthritis, multiple myeloma, graft-versus-host disease, pyoderma gangrenosum, inflammatory bowel disease, Sjögren's syndrome and a variety of solid tumours is currently being explored.
Use of Ghrelin and Ghrelin Receptor Agonists in Cancer- and Chemotherapy-Induced Cachexia
More studies are needed looking into the long-term safety and efficacy of ghrelin and its mimetics in cancer patients and other chronic diseases associated with cachexia.


Is there a role for melatonin in the treatment of neoplastic cachexia?
Megestrol Acetate in Patients with AIDS-related Cachexia
This multicenter, double-blind, placebo-controlled study was designed to assess the safety and efficacy of megestrol acetate for the treatment of AIDS-related anorexia and cachexia in patients with AIDS-associated weight loss.
A controlled trial of cyproheptadine in cancer patients with anorexia and/or cachexia
A randomized, placebo‐controlled, double‐blinded clinical trial using cyproheptadine, 8 mg orally three times a day in 295 patients with advanced malignant disease found that it did not significantly abate progressive weight loss.
Anorexia and cachexia in advanced cancer patients.
Cachexia is a frequent and devastating complication of advanced cancer. Current understanding of the pathophysiology of this syndrome implicates tumour induced metabolic changes and immune responses.
Anti-inflammatory treatment may prolong survival in undernourished patients with metastatic solid tumors.
The results suggest that not only may prostaglandin synthesis inhibition offer palliative support to patients with solid advanced cancer, but it may also impact on pathways that ultimately determine outcome.
Megestrol Acetate in Patients with AIDS and Cachexia
This multicenter, double-blind, placebo-controlled clinical trial compared the effects of high-dose megestrol acetate and placebo on the medical status of patients with AIDS who had cachexia and anorexia.
Pentoxifylline for treatment of cancer anorexia and cachexia? A randomized, double-blind, placebo-controlled trial.
This study failed to demonstrate any benefit of pentoxifylline at this dose and schedule as therapy for cancer anorexia and/or cachexia.
A double blind placebo controlled trial of medroxyprogesterone acetate (MPA) in cancer cachexia.
Data indicate that there was a significant increase in appetite in anorexic patients with advanced cancer treated with MPA which was reflected in increases in rapid turnover proteins reported to reflect nutritional status, but this apparent increased in appetite did not result in improved weight, performance status, energy levels, mood or relief of pain.