Cachexia: clinical features when inflammation drives malnutrition

Laviano, Alessandro; Koverech, Aleardo; Mari, A.

doi:10.1017/s0029665115000117

Cited by 46 publications

(45 citation statements)

References 39 publications

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“…The interactions between malnutrition, cachexia, and inflammation have been widely investigated but remain a matter of debate . What seems clear is that a nutritional assessment, which should include an SMM evaluation, could be seen in a new light after the advent of immune checkpoint inhibitors (ICIs).…”

Section: Introductionmentioning

confidence: 99%

Predictive value of skeletal muscle mass for immunotherapy with nivolumab in non‐small cell lung cancer patients: A “hypothesis‐generator” preliminary report

et al. 2019

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Sarcopenia represents one of the hallmarks of all chronic disease, including non‐small cell lung cancer (NSCLC). A computed tomography scan is an easy modality to estimate the skeletal muscle mass through cross‐sectional image analysis at the level of the third lumbar vertebra (L3). Baseline skeletal muscle mass (SMM) was evaluated using gender‐specific cutoffs for skeletal muscle index in NSCLC patients administered immunotherapy with nivolumab to evaluate its possible correlations with clinical outcomes. From April 2015 to August 2018, 23 stage IV NSCLC patients were eligible for image analysis. Nine patients (39.1%) had low SMM. Among patients with baseline low and non‐low SMM, median progression free survival was 3.1 and 3.8 months, respectively (P = 0.0560), while median overall survival was 4.1 and 13 months, respectively (P = 0.2866). This hypothesis‐generating preliminary report offers the opportunity to speculate about the negative influence of sarcopenia on immune response. In our opinion, nutritional status could affect the clinical outcomes of immunotherapy, even if we cannot make definitive conclusions here. Further studies on the topic are required.

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Section: Introductionmentioning

confidence: 99%

Predictive value of skeletal muscle mass for immunotherapy with nivolumab in non‐small cell lung cancer patients: A “hypothesis‐generator” preliminary report

et al. 2019

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“…A lack of uniform clinical knowledge and an absence of diagnostic criteria for cachexia in patients with ESRD hinders both research and clinical management of this condition and is likely to have a negative impact on a range of health outcomes including patient survival (Laviano et al 2015). Therefore, it is important to assess awareness and understanding of cachexia to help improve early identification, treatment and support for patients and their families.…”

Section: Discussionmentioning

confidence: 99%

Awareness, Understanding and Treatment Practices when Managing Cachexia in End‐Stage Kidney Disease

McKeaveney

Noble

Barbieri

et al. 2019

Journal of Renal Care

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SUMMARY Background Cachexia is a wasting syndrome found within a range of chronic illnesses/life‐limiting conditions, however awareness and understanding of cachexia amongst renal Health Care Professionals has not been investigated. Objectives To ascertain the awareness, understanding and treatment practices of Health Care Professionals who provide care for people with cachexia and end‐stage renal disease. Methods Health Care Professionals were recruited via the European Dialysis and Transplant Nurses Association/European Renal Care Association in September 2018. This was an exploratory study using a mixed‐methods approach with those who provide care for patients with end‐stage renal disease and cachexia. An online survey and two focus groups were conducted. Descriptive statistics and inductive thematic analysis were used to explore current knowledge and practices in renal cachexia. Results A total of 93 participants from 30 countries completed the online survey. Twelve Health Care Professionals agreed to participate in the focus groups. Reduced appetite, weight loss and muscle loss in relation to cachexia were accurately described, but the percentage of weight loss was unknown. The importance of multi‐professional collaboration was recognised, however, the current management of cachexia was wide‐ranging. Quality of life, patient‐clinician communication and specialist support for carers were regarded as vital. Conclusion Timely identification and management of cachexia are needed to improve the quality of life for patients and appropriately support families. In order for these goals to be achieved, there is a need to increase awareness and understanding of cachexia amongst renal nurses.

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“…15 The mechanism of brown adipocyte inhibition is through inactivation of sympathetic nervous system output. 16 Its stimulation of lipogenic pathways through gene expression of lipogenic enzymes, such as acetyl-CoA carboxylase, stearoyl CoA desaturase, and fatty acid synthase, in white adipose tissue leads to adipose formation. 17 …”

Section: Ghrelin Physiologymentioning

confidence: 99%

Oncology Update: Anamorelin

Prommer¹

2017

Palliat�Care

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Background:Cancer cachexia is a catabolic syndrome associated with uncontrolled muscle breakdown. There may be associated fat loss. Occurring in high frequency in advanced cancer, it is an indicator of poor prognosis. Besides weight loss, patients experience a cluster of symptoms including anorexia, early satiety, and weakness. The 3 stages of cachexia include stages of precachexia, cachexia, and refractory cachexia. Refractory cachexia is associated with active catabolism or the presence of factors that make active management of weight loss no longer possible. Patients with refractory cachexia often receive glucocorticoids or megasterol acetate. Glucocorticoid effect is short and responses to megasterol are variable. Anamorelin is a new agent for cancer anorexia-cachexia, with trials completed in advanced lung cancer. Acting as an oral mimetic of ghrelin, it improves appetite and muscle mass. This article reviews the pharmacology, pharmacodynamics, and effect on cancer cachexia.Methods:A PubMed search was done using the Medical Subject Headings term anamorelin. Articles were selected to provide a pharmacologic characterization of anamorelin.Results:Anamorelin increases muscle mass in patients with advanced cancer in 2-phase 3 trials.Conclusions:Anamorelin improves anorexia-cachexia symptoms in patients with advanced non–small-cell lung cancer.

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Cachexia: clinical features when inflammation drives malnutrition

Abstract: Conference on 'Nutrition and age-related muscle loss, sarcopenia and cachexia' Symposium 1: Sarcopenia and cachexia: scale of the problem, importance, epidemiology and measurement

Cited by 46 publications

References 39 publications

Predictive value of skeletal muscle mass for immunotherapy with nivolumab in non‐small cell lung cancer patients: A “hypothesis‐generator” preliminary report

Predictive value of skeletal muscle mass for immunotherapy with nivolumab in non‐small cell lung cancer patients: A “hypothesis‐generator” preliminary report

Awareness, Understanding and Treatment Practices when Managing Cachexia in End‐Stage Kidney Disease

Oncology Update: Anamorelin

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