Cancer Cachexia overview

Cachexia has been recognised for a long time as an adverse effect of cancer and it has been estimated that cachexia affects 50–80% of cancer patients and accounts for up to 20% of cancer deaths1.

The definition of cancer cachexia is “weight loss greater than 5%, or weight loss greater than 2% in individuals already showing depletion according to current bodyweight and height (body-mass index [BMI] <20 kg/m(2)) or skeletal muscle mass (sarcopenia)”.2

Solid tumour types such as colorectal cancer (CRC) and non-small cell lung cancer (NSCLC) have relatively high incidences of cachexia, (approximately 50%2,3). However, the presence of cachexia in any cancer type is associated with reduced physical function, poor mortality outcomes and a poorer prognosis when compared to patients with no weight loss4,5.

The presence of cachexia reduces the impact of anti-cancer treatment and this in turn aggravates the effect of underlying and associated conditions resulting in lower rates of survival6,7,8.

Weight loss in patients with cancer is rarely recognised, assessed or managed actively. Other than supportive care, no approved treatments are available for this patient population. Thus, cancer cachexia represents an important unmet need.

Cancer cachexia remains a significant hurdle in the treatment of cancer and results in a high medical, social and economic burden for health care providers as well as a significant emotional strain on patients and loved ones.

 

References

1Argilés JM, Busquets S, Stemmler B, Lopez-Soriano FJ. Cancer cachexia: understanding the molecular basis. Nat Rev Cancer. 2014;14:754–62.

2Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 2011;12:489–495.

3Tan BHL et al., Cachexia: prevalence and impact in medicine. Curr Opin Clin Nutr Metab Care 2008;11(4):400-7

4 Dewys WD et al., Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med 1980;69(4):491-97.

5Del Fabbro E, Inui A, Strasser F., Cancer Cachexia. Pocket book for cancer supportive care. Springer Healthcare 2012.

6Dewys WD. Begg C. Lavin PT. Band PR. Bennett JM. Bertino JR. Cohen MH. Douglass HO., Jr Engstrom PF. Ezdinli EZ. Horton J. Johnson GJ. Moertel CG. Oken MM. Perlia C. Rosenbaum C. Silverstein MN. Skeel RT. Sponzo RW. Tormey DC. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980:69491–497.

 7Ross PJ. Ashley S. Norton A. Priest K. Waters JS. Eisen T. Smith IE. O'Brien ME. Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers? Br J Cancer. 2004;90:1905–1911.

 8Fein R. Kelsen DP. Geller N. Bains M. McCormack P. Brennan MF. Adenocarcinoma of the esophagus and gastroesophageal junction. Prognostic factors and results of therapy. Cancer. 1985;56:2512–2518.