Inflammation as a Therapeutic Target in Cancer Cachexia

SIMPLE SUMMARY: Weight loss, called cachexia, often occurs in cancer patients, and is associated with poor quality of life and shorter survival. Cancer cachexia is associated with increased circulating inflammatory factors, but efforts to reduce levels of inflammation using a single agent have not been successful. Cachexia likely results from many causes, including inflammatory cytokines, anorexia, catabolism, depression, and pain, and targeting the multiple causes will likely be necessary to achieve improvement in weight and appetite. In this review, we explore some potential therapies to address the need for anti-cachexia therapy with an emphasis on existing therapies that may be able to be re-purposed, therapies targeting inflammation, and the likely need for combination therapy directed at the complex causes of cancer cachexia. ABSTRACT: Cachexia is a common complication of cancer and is associated with poor quality of life and a decrease in survival. Many patients with cancer cachexia suffer from inflammation associated with elevated cytokines, such as interleukin-1beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor (TNF). Single-agent trials to treat cancer cachexia have not led to substantial benefit as the type of cytokine which is elevated has rarely been specified and targeted. Cachexia may also be multifactorial, involving inflammation, anorexia, catabolism, depression, and pain, and targeting the multiple causes will likely be necessary to achieve improvement in weight and appetite. A PUBMED search revealed over 3000 articles on cancer cachexia in the past ten years. We attempted to review any studies related to inflammation and cancer cachexia identified by Google Scholar and PUBMED and further search for articles listed in their references. The National Comprehensive Cancer Network (NCCN) guidelines do not provide any suggestion for managing cancer cachexia except a dietary consult. A more targeted approach to developing therapies for cancer cachexia might lead to more personalized and effective therapy.