Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Department of Surgery, Yokohama City University, Yokohama, Japan.
Anticancer Res. 2023 Feb;43(2):511-521. doi: 10.21873/anticanres.16188.
Cancer cachexia demonstrates the same pathology as cachexia found in patients with disease-associated malnutrition presenting with inflammation. In advanced cancer, a decrease in skeletal muscle mass progresses with an increase in cancer cell mass. Moreover, cancer cachexia causes systemic edema and cachexia, reduces the efficacy of chemotherapy, and negatively affects cancer prognosis. Early nutritional intervention and multidisciplinary care are essential to ensure sufficient nutritional requirements and minimize anabolic resistance factors. In addition, preventive care that minimizes deterioration of nutritional status and loss of skeletal muscle mass is required for the effective treatment of cachexia. Therefore, the current review sought to comprehensively describe the available evidence for the effective pharmaceutical treatment of cancer-associated cachexia. Steroids have traditionally been used for cachexia drug therapy. However, their effects are limited, and it is difficult to radically restore the highly reduced muscle mass inherent to cancer-associated cachexia. Recently, anamorelin hydrochloride, an endogenous ligand for the growth hormone release-promoting factor receptor, which has a similar pharmacological action to that of ghrelin, was developed to treat weight loss accompanied by anorexia. This medication also treats cachexia and was the first drug to be approved for this purpose. Anamorelin hydrochloride is expected to bring new advancements into the field of clinical oncology as an effective therapeutic drug for cancer cachexia, a devastating complication that, so far, has no definitive and effective treatment.
癌症恶病质与与疾病相关的营养不良患者中发现的恶病质具有相同的病理学特征,这些患者伴有炎症。在晚期癌症中,骨骼肌量减少与癌细胞量增加同时发生。此外,癌症恶病质会导致全身水肿和恶病质,降低化疗效果,并对癌症预后产生负面影响。早期进行营养干预和多学科护理对于确保充足的营养需求和最小化合成代谢抵抗因素至关重要。此外,为了有效治疗恶病质,还需要进行预防护理,以尽量减少营养状况恶化和骨骼肌量的丧失。因此,本综述旨在全面描述癌症相关恶病质的有效药物治疗的现有证据。类固醇传统上一直用于恶病质的药物治疗。然而,它们的效果有限,并且很难从根本上恢复癌症相关恶病质中固有地高度减少的肌肉质量。最近,盐酸氨基瑞林被开发用于治疗伴有厌食症的体重减轻,这是一种内源性生长激素释放促进因子受体配体,其药理作用与胃饥饿素相似。这种药物还可以治疗恶病质,是第一种为此目的获得批准的药物。盐酸氨基瑞林有望成为癌症恶病质的有效治疗药物,为临床肿瘤学领域带来新的进展,癌症恶病质是一种破坏性的并发症,迄今为止尚无明确有效的治疗方法。