Cancer cachexia often occurs in malignant tumors and is a multifactorial and complex symptom characterized by wasting of skeletal muscle and adipose tissue, resulting in weight loss, poor life quality and shorter survival. The pathogenic mechanism of cancer cachexia is complex, involving a variety of molecular substrates and signal pathways. Advancements in understanding the molecular mechanisms of cancer cachexia have provided a platform for the development of new targeted therapies. Although recent outcomes of early-phase trials have showed that several drugs presented an ideal curative effect, monotherapy cannot be entirely satisfactory in the treatment of cachexia-associated symptoms due to its complex and multifactorial pathogenesis. Therefore, the lack of definitive therapeutic strategies for cancer cachexia emphasizes the need to develop a better understanding of the underlying mechanisms. Increasing evidences show that the progression of cachexia is associated with metabolic alternations, which mainly include excessive energy expenditure, increased proteolysis and mitochondrial dysfunction. In this review, we provided an overview of the key mechanisms of cancer cachexia, with a major focus on muscle atrophy, adipose tissue wasting, anorexia and fatigue and updated the latest progress of pharmacological management of cancer cachexia, thereby further advancing the interventions that can counteract cancer cachexia.
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Cover Image
In this issue Samantha and colleagues (pp. 1749–1767) provide insights into the underlying mechanism that governs the recognition of myo-inositol by TNYR SaPLD. The image shows an overlay of the loop conformations of four different structures. The unliganded TNYR structure is coloured magenta, in teal is the structure of the H168A mutant bound to PA, in green is the WT unliganded structure and in grey is the TNYR structure bound to phosphate. Image courtesy of Alice Vrielink.
Cancer cachexia: molecular mechanism and pharmacological management
Yonghua Li, Huan Jin, Yibing Chen, Ting Huang, Yanjun Mi, Zhengzhi Zou; Cancer cachexia: molecular mechanism and pharmacological management. Biochem J 14 May 2021; 478 (9): 1663–1688. doi: https://doi.org/10.1042/BCJ20201009
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