Clinical evaluation and optimal management of cancer cachexia

Crit Rev Oncol Hematol. 2013 Dec;88(3):625-36. doi: 10.1016/j.critrevonc.2013.07.015. Epub 2013 Aug 15.


Cancer anorexia-cachexia syndrome (CACS) is a complex metabolic syndrome, different from malnutrition and sarcopenia, which is very common in cancer patients. Treatment for CACS is based on nutritional support and CACS pathophysiology-modulating drugs. The most commonly used are megestrol acetate (MA) and corticosteroids. The efficacy of MA has been confirmed by multiple clinical trials and meta-analyses. Glucocorticoids are also effective but should only be used for short periods and in selected cases. Future strategies should include intensified research into potentially effective drugs (ω-3 fatty acids, thalidomide, cannabinoids, ghrelin, bortezomib, and COX-2 inhibitors), combined treatment and new drugs (anti-IL-6 monoclonal antibodies, melanocortin, β-2 antagonists, and androgen receptor-modulating analogues). We propose a review based on the literature on the pathophysiology of CACS, the diagnostic criteria and treatment, and future strategies.

Keywords: Anorexia; Cachexia; Cancer; Malnutrition; Megestrol acetate.

Publication types

  • Review

MeSH terms

  • Cachexia / diagnosis*
  • Cachexia / epidemiology
  • Cachexia / etiology
  • Cachexia / psychology
  • Cachexia / therapy*
  • Humans
  • Neoplasms / complications*