Park Margaret A, Whelan Christopher J, Ahmed Sabeen, Boeringer Tabitha, Brown Joel, Crowder Sylvia L, Gage Kenneth, Gregg Christopher, Jeong Daniel K, Jim Heather S L, Judge Andrew R, Mason Tina M, Parker Nathan, Pillai Smitha, Qayyum Aliya, Rajasekhara Sahana, Rasool Ghulam, Tinsley Sara M, Schabath Matthew B, Stewart Paul, West Jeffrey, McDonald Patricia, Permuth Jennifer B
Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
Cancers (Basel). 2024 Jun 27;16(13):2364. doi: 10.3390/cancers16132364.
For many patients, the cancer continuum includes a syndrome known as cancer-associated cachexia (CAC), which encompasses the unintended loss of body weight and muscle mass, and is often associated with fat loss, decreased appetite, lower tolerance and poorer response to treatment, poor quality of life, and reduced survival. Unfortunately, there are no effective therapeutic interventions to completely reverse cancer cachexia and no FDA-approved pharmacologic agents; hence, new approaches are urgently needed. In May of 2022, researchers and clinicians from Moffitt Cancer Center held an inaugural retreat on CAC that aimed to review the state of the science, identify knowledge gaps and research priorities, and foster transdisciplinary collaborative research projects. This review summarizes research priorities that emerged from the retreat, examples of ongoing collaborations, and opportunities to move science forward. The highest priorities identified include the need to (1) evaluate patient-reported outcome (PRO) measures obtained in clinical practice and assess their use in improving CAC-related outcomes; (2) identify biomarkers (imaging, molecular, and/or behavioral) and novel analytic approaches to accurately predict the early onset of CAC and its progression; and (3) develop and test interventions (pharmacologic, nutritional, exercise-based, and through mathematical modeling) to prevent CAC progression and improve associated symptoms and outcomes.
对于许多患者而言，癌症进程包括一种被称为癌症恶病质（CAC）的综合征，它包括非故意的体重和肌肉量减轻，且常伴有脂肪减少、食欲下降、耐受性降低、对治疗的反应较差、生活质量差以及生存期缩短。不幸的是，目前尚无有效的治疗干预措施能完全逆转癌症恶病质，也没有获得美国食品药品监督管理局（FDA）批准的药物；因此，迫切需要新的方法。2022年5月，莫菲特癌症中心的研究人员和临床医生就癌症恶病质举行了首次务虚会，旨在审视科学现状、确定知识空白和研究重点，并促进跨学科合作研究项目。本综述总结了务虚会提出的研究重点、正在进行的合作实例以及推动科学进步的机会。确定的首要重点包括需要：（1）评估在临床实践中获得的患者报告结局（PRO）指标，并评估其在改善与癌症恶病质相关结局方面的用途；（2）识别生物标志物（影像学、分子和/或行为学方面的）以及新颖的分析方法，以准确预测癌症恶病质的早期发作及其进展；（3）开发并测试干预措施（药物、营养、基于运动的以及通过数学建模的干预措施），以防止癌症恶病质进展并改善相关症状和结局。
