Update on emerging drugs for cancer cachexia

Abstract

Cancer cachexia is a complex syndrome that describes the progressive muscle wasting and weakness in many cancer patients. Muscle wasting reduces the ability of affected patients to perform the tasks of daily living and causes severe fatigue, leading to a reduction in quality of life. Cancer cachexia reduces patient response to anti-neoplastic treatments, increases the risk of postoperative complications and accounts for > 20% of cancer-related deaths. The pathogenesis of cancer cachexia is multifactorial and includes anorexia, inflammation, metabolic disturbances and enhanced muscle proteolysis, and each of these presents as a potential therapeutic target for ameliorating cancer cachexia. Objective: This review provides an update on some of the emerging drugs for cancer cachexia. Methods: This is a review of the current status of emerging therapies for cancer cachexia. Results: An increasing number of studies are focused on the development of novel therapies for cancer cachexia. Initial studies concentrated on the treatment of anorexia, but now aim to attenuate inflammation or muscle proteolysis, or to use different drugs in combination so as to treat several aspects of cachexia simultaneously. Conclusions: There are several existing and emerging drugs with the potential to ameliorate cancer cachexia, but the most efficacious treatment will probably come from combined drug therapies.

Keywords::

• anorexia
• asthenia
• cancer cachexia
• muscle wasting
• skeletal muscle
• tumour

Acknowledgements

The Basic and Clinical Myology Laboratory gratefully acknowledges the generous research funding received from the Australian Research Council Discovery-Project funding scheme (DP0772781), National Health and Medical Research Council of Australia (NHMRC 454561, 509313, 566818, 566820), Muscular Dystrophy Association (USA, 4167), Association Française contre les Myopathies, Rebecca L. Cooper Medical Research Foundation, Pfizer, Inc. (USA), F. Hoffmann-La Roche Ltd (Switzerland) and Merck & Co., Inc. (USA).

KT Murphy is a Peter Doherty Research Fellow of the National Health and Medical Research Council (Australia).