Cancer Cachexia: Identification by Clinical Assessment versus International Consensus Criteria in Patients with Metastatic Colorectal Cancer

Werf, A. van der; Bokhorst, Querijn N. E. van; Schueren, Marian A.E. de van der; Verheul, Henk M.W.; Langius, J.A.E.

doi:10.1080/01635581.2018.1504092

Cited by 16 publications

(13 citation statements)

References 32 publications

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“…To date, CC classification work has centered on validation or refinement of the proposed diagnostic criteria in research settings. 2,5,29 Only one study 17 has evaluated the agreement between CC by clinical presentation and the ICC stages. Clinical assessment comprised an oncologist's opinion based on (undefined) clinical presentation (ie, cachectic vs not cachectic).…”

Section: Discussionmentioning

confidence: 99%

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Application of the 2011 international consensus cancer cachexia classification in routine oncology dietetic practice: An observational study

et al. 2022

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Background Cancer cachexia (CC) is highly prevalent and associated with significant morbidity and mortality, yet underrecognized. In 2011, an international cachexia consensus (ICC) proposed a definition, assessment framework, and stages for classification: cancer precachexia, cachexia, and refractory cachexia. The authors anticipated that a “more practical classification approach for clinical practice” would be required, which we interpreted as a bedside assessment based on clinical data. We investigated whether the ICC classification could be employed in routine dietetic practice without access to objective muscle mass measures. Methods Data from 200 consecutive patients with solid tumors were collected as part of clinical practice by oncology dietitians in five tertiary referral hospitals. Dietitians used information gathered during their routine assessment and applied the ICC framework to assign a stage. When the dietitian was unable to assign a stage, the reason was noted. Results Based on available data, classification was possible in 177 (88%); 23 (12%) could not be staged. The reasons cited were as follows: unknown C‐reactive protein (n = 14), complex clinical situation (n = 5), unknown weight loss (n = 2), and acute illness (n = 2). Thirty (17%) of the 177 participants were judged to be noncachectic. One hundred twelve (83%) met the criteria for 1 of the 3 ICC stages: 92 (52%) were cachectic; 35 (20%) precachectic, and 20 (11%) refractory. Conclusions CC staging based on the ICC classification was feasible and practical in routine dietetic practice even without access to objective muscle mass measures. Once validated and operationalized, expert clinical assessment by a dietitian could be a cost‐effective means to identify and stage CC, with more resource‐intensive means used when there is clinical doubt.

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Section: Discussionmentioning

confidence: 99%

“…14 Prior studies 15,16 have also demonstrated that oncology nurses are not appropriately educated to recognize and manage CC. Van der Werf et al 17 found weak agreement between an oncologist's CC assessment by clinical presentation and the ICC classification. Oncologists may lack confidence in identifying malnutrition.…”

Section: Introductionmentioning

confidence: 99%

Application of the 2011 international consensus cancer cachexia classification in routine oncology dietetic practice: An observational study

et al. 2022

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“…CCM contains factors that inhibit both myoblast proliferation and myogenic differentiation [ 39 ]. The in vitro and in vivo experiments in this study utilized the CT26 colon carcinoma cell line because cancer cachexia is commonly associated with this tumor type [ 65 ]. Cancer cachexia is a common complication of lung, breast, and pancreatic carcinoma [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

Lithium Chloride Protects against Sepsis-Induced Skeletal Muscle Atrophy and Cancer Cachexia

Lee

Kim

et al. 2021

Cells

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Inflammation-mediated skeletal muscle wasting occurs in patients with sepsis and cancer cachexia. Both conditions severely affect patient morbidity and mortality. Lithium chloride has previously been shown to enhance myogenesis and prevent certain forms of muscular dystrophy. However, to our knowledge, the effect of lithium chloride treatment on sepsis-induced muscle atrophy and cancer cachexia has not yet been investigated. In this study, we aimed to examine the effects of lithium chloride using in vitro and in vivo models of cancer cachexia and sepsis. Lithium chloride prevented wasting in myotubes cultured with cancer cell-conditioned media, maintained the expression of the muscle fiber contractile protein, myosin heavy chain 2, and inhibited the upregulation of the E3 ubiquitin ligase, Atrogin-1. In addition, it inhibited the upregulation of inflammation-associated cytokines in macrophages treated with lipopolysaccharide. In the animal model of sepsis, lithium chloride treatment improved body weight, increased muscle mass, preserved the survival of larger fibers, and decreased the expression of muscle-wasting effector genes. In a model of cancer cachexia, lithium chloride increased muscle mass, enhanced muscle strength, and increased fiber cross-sectional area, with no significant effect on tumor mass. These results indicate that lithium chloride exerts therapeutic effects on inflammation-mediated skeletal muscle wasting, such as sepsis-induced muscle atrophy and cancer cachexia.

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“…The clinical definition of CAC by Fearon criteria includes the following characteristics: weight loss > 5% or weight loss > 2% and a BMI < 20 kg/m 2 or sarcopenia [ 46 ]. In this study, 15- to 24-week-old Apc Min/+ mice with weight loss > 15%, as well as skeletal muscle (gastrocnemius and soleus) loss, and certain other symptoms such as anemia, were considered as the characteristics of CAC.…”

Section: Discussionmentioning

confidence: 99%

MMP12 knockout prevents weight and muscle loss in tumor-bearing mice

Jiang

Yang

et al. 2021

BMC Cancer

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Background Colorectal cancer is a malignant gastrointestinal cancer, in which some advanced patients would develop cancer cachexia (CAC). CAC is defined as a multi-factorial syndrome characterized by weight loss and muscle loss (with or without fat mass), leading to progressive dysfunction, thereby increasing morbidity and mortality. ApcMin/+ mice develop spontaneous intestinal adenoma, which provides an established model of colorectal cancer for CAC study. Upon studying the ApcMin/+ mouse model, we observed a marked decrease in weight gain beginning around week 15. Such a reduction in weight gain was rescued when ApcMin/+ mice were crossed with MMP12−/− mice, indicating that MMP12 has a role in age-related ApcMin/+-associated weight loss. As a control, the weight of MMP12−/− mice on a weekly basis, their weight were not significantly different from those of WT mice. Methods ApcMin/+; MMP12−/− mice were obtained by crossing ApcMin/+ mice with MMP12 knockout (MMP12 −/−) mice. Histological scores were assessed using hematoxylin-eosin (H&E) staining. MMP12 expression was confirmed by immunohistochemistry and immunofluorescence staining. ELISA, protein microarrays and quantitative Polymerase Chain Reaction (qPCR) were used to investigate whether tumor could up-regulate IL-6. Cell-based assays and western blot were used to verify the regulatory relationship between IL-6 and MMP12. Fluorescence intensity was measured to determine whether MMP12 is associated with insulin and insulin-like growth factor 1 (IGF-1) in vitro. MMP12 inhibitors were used to explore whether MMP12 could affect the body weight of ApcMin/+ mice. Results MMP12 knockout led to weight gain and expansion of muscle fiber cross-sectional area (all mice had C57BL/6 background) in ApcMin/+ mice, while inhibiting MMP12 could suppress weight loss in ApcMin/+ mice. MMP12 was up-regulated in muscle tissues and peritoneal macrophages of ApcMin/+ mice. IL-6 in tumor cells and colorectal cancer patients is up-regulation. IL-6 stimulated MMP12 secretion of macrophage. Conclusions MMP12 is essential for controlling body weight of Apc Min/+ mice. Our study shows that it exists the crosstalk between cancer cells and macrophages in muscle tissues that tumor cells secrete IL-6 inducing macrophages to up-regulate MMP12. This study may provide a new perspective of MMP12 in the treatment for weight loss induced by CAC.

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Cancer Cachexia: Identification by Clinical Assessment versus International Consensus Criteria in Patients with Metastatic Colorectal Cancer

Cited by 16 publications

References 32 publications

Application of the 2011 international consensus cancer cachexia classification in routine oncology dietetic practice: An observational study

Application of the 2011 international consensus cancer cachexia classification in routine oncology dietetic practice: An observational study

Lithium Chloride Protects against Sepsis-Induced Skeletal Muscle Atrophy and Cancer Cachexia

MMP12 knockout prevents weight and muscle loss in tumor-bearing mice

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