Special Issue "Cancer Cachexia"
A special issue of Cancers (ISSN 2072-6694).
Deadline for manuscript submissions: closed (31 October 2019).
2. Indiana University Simon Cancer Center; Richard Roudebush VAMC, Indianapolis, IN 46202, USA
Interests: pancreatic cancer; muscle atrophy; cancer cachexia; symptom science; cancer metabolism
Cachexia is an underappreciated cause of cancer patient morbidity and mortality. It is associated with an impaired response to treatment, increased risk of treatment-related complications, decreased quality of life, and shortened survival. Key clinical components of the cachexia syndrome include wasting of peripheral tissues (namely, skeletal muscle and adipose tissue), primary anorexia, alterations in circulating neuroendocrine hormones, and induction of a systemic inflammatory response. Cachexia is driven by tumor-derived mediators that signal to disrupt host immunity and metabolism. Much progress has been made in the past 20 years in identifying molecular and cellular mediators of cancer cachexia. Major questions remain, however, particularly in understanding tumor–organ crosstalk, in identifying key nodes upstream of known cytokine cascades and inflammation, and in defining targetable end organ responses to cachexia-causing tumors. Additionally, understanding the link between metabolic dysregulation of cachexia and immune suppression could improve the efficacy of immunotherapy.
Despite increased understanding of pathological mechanisms of cachexia and a considerable uptick in anticachexia trials, there is still no effective approved therapy that can prevent or reverse cancer cachexia. Although certain ghrelin analogs and selective androgen receptor modulators have shown to be beneficial in terms of increasing patient lean body mass, these trials have been unable to demonstrate an associated gain in patient functional status. Trial methodology has improved with consensus definitions for clinical cachexia and the use of body composition analysis via diagnostic imaging modalities. However, further improvements in trial methodology, including the identification of early biomarkers, the accommodation of multimodal treatment regimens, and the development of robust coprimary endpoints, are required.
This Special Issue of Cancers will highlight the current state-of-the-art in cachexia biology and develop our understanding of the complexity of this syndrome. Research articles and review articles reporting basic science, translational studies, and clinical studies are all encouraged.
Dr. Teresa A. Zimmers
Dr. Richard Skipworth
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