Del Fabbro Egidio
From the Palliative Care Program, Virginia Commonwealth University, Richmond, VA.
Am Soc Clin Oncol Educ Book. 2015:e229-37. doi: 10.14694/EdBook_AM.2015.35.e229.
Many important advances have occurred in the field of cancer cachexia over the past decade, including progress in understanding the mechanisms of the cancer anorexia-cachexia syndrome (CACS) and the development of promising pharmacologic and supportive care interventions. However, no approved agents for cancer cachexia currently exist, emphasizing the unmet need for an effective pharmacologic therapy. This article reviews the key elements of CACS assessment in daily practice, the contribution of nutritional impact symptoms (NIS), the evidence for current pharmacologic options, and promising anticachexia agents in perclinical and clinical trials. It also proposes a model for multimodality therapy and highlights issues pertinent to CACS in patients with pancreatic, gastric, and esophageal cancer.
在过去十年中，癌症恶病质领域取得了许多重要进展，包括在理解癌症厌食-恶病质综合征（CACS）机制方面取得的进展以及有前景的药物和支持性护理干预措施的开发。然而，目前尚无获批用于治疗癌症恶病质的药物，这凸显了对有效药物治疗的未满足需求。本文回顾了日常实践中CACS评估的关键要素、营养影响症状（NIS）的作用、当前药物选择的证据以及临床前和临床试验中有前景的抗恶病质药物。本文还提出了一种多模式治疗模型，并强调了胰腺癌、胃癌和食管癌患者中与CACS相关的问题。
