Skip to main content
SpringerLink
Log in

A Review of the Drug Treatment of Cachexia Associated with Cancer

  • Review Article
  • Published:
Drugs Aims and scope Submit manuscript

Summary

In the past 20 years, cachexia in cancer patients has attracted increasing interest from both clinicians and basic researchers. It is now clear that the cachexia is secondary to major metabolic abnormalities due to tumour by-products and cytokine release. These metabolic abnormalities produce numerous symptoms such as cachexia, anorexia and asthenia.

There are now effective drugs such as corticosteroids and progestational drugs that have been shown to improve appetite, food intake and sensation of well-being,and which elicit bodyweight gain. While hydrazine (hydrazine sulfate) has received much attention, unfortunately it has been shown to be ineffective in improving the symptoms of the patient with cancer cachexia. A new group of drugs, such as thalidomide and melatonin because of their effects on tumour necrosis factor-α, and β2-adrenoceptor agonists because of their effects on muscle metabolism, and other agents, is presently reaching the clinical trial stage. There is now the possibility of addressing this fascinating syndrome at a different level and an opportunity for combined therapy to try to improve the quality of life of these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bruera E, MacDonald RN. Nutrition in cancer patients: an update and review of our experience. J Pain Symptom Manage 1988; 3(3): 133–40

    PubMed  CAS  Google Scholar 

  2. Dunlop R. Clinical epidemiology of cancer cachexia. In: Bruera E, Higginson I, editors. Cachexia-anorexia in cancer patients. Oxford: Oxford University Press, 1996: 76–82

    Google Scholar 

  3. Billingsly KG, Alexander HR. The pathophysiology of cachexia in advanced cancer and AIDS. In: Bruera E, Higginson I, editors. Cachexia-anorexia in cancer patients. Oxford: Oxford University Press, 1996: 1–22

    Google Scholar 

  4. Watanabe S, Bruera E. Anorexia and cachexia, asthenia and lethargy. In: Cherny N, Foley K, editors. Hematology/oncology clinics of North America: pain and palliative care. Philadelphia: WB Saunders Company, 1996; 189–206

    Google Scholar 

  5. Vigano A, Bruera E. Enterai and parenteral nutrition in cancer patients. In: Bruera E, Higginson I, editors. Cachexia-anorexia in cancer patients. Oxford: Oxford University Press, 1996: 110–27

    Google Scholar 

  6. Twomey PL. Cross-effectiveness of total parenteral nutrition. In: JL Rombeau, MD Caldwell, editors. Clinical nutrition: parenteral nutrition. 2nd ed. Philadelphia: Saunders, 1993; 401–8

    Google Scholar 

  7. Veterans Affairs Total Parenteral Nutrition Study Group. Perioperative total parenteral nutrition in surgical patients. N Engl J Med 1991; 325(8): 525–33

    Google Scholar 

  8. Vigano A, Watanabe S, Bruera E. Anorexia and cachexia in advanced cancer patients. In: Sidebottom E, editor. Cancer surveys. 1994: 99–115

    Google Scholar 

  9. DeWys WD, Begg C, Lavin PT, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med 1980; 69: 491–7

    Google Scholar 

  10. Ingham J, Portenoy R. Cachexia in context: the interactions among anorexia, pain, and other symptoms. In: Bruera E, Higginson I, editors. Cachexia-anorexia in cancer patients. Oxford: Oxford University Press, 1996: 158–71

    Google Scholar 

  11. Apfelbaum-Kowalski E. Pathophysiology of the circulatory system in hunger disease. In: Winick M, editor. Hunger disease: studies by the Jewish physicians in the Warsaw ghetto. New York: John Wiley and Sons, 1979: 125–60

    Google Scholar 

  12. Roca E, Bruera E, Politi P, et al. Vinca alkaloids—induced cardiovascular autonomic neuropathy. Cancer Treat Rep 1985; 69(2): 149–51

    PubMed  CAS  Google Scholar 

  13. Kris M, Yeh S, Gralla RJ, et al. Symptomatic gastroparesis in cancer patients: a possible cause of cancer associated with anorexia [abstract no. C-1038]. Proc Am Soc Clin Oncol 1985; 4: 267

    Google Scholar 

  14. Bruera E, Chadwick S, MacDonald N, et al. Study of cardiovascular autonomic insufficiency in advanced cancer patients. Cancer Treat Rep 1986; 70(12): 1383–7

    PubMed  CAS  Google Scholar 

  15. Bruera E, Catz Z, Hooper R, et al. Chronic nausea and anorexia in patients with advanced cancer: a possible role for autonomic dysfunction. J Pain Symptom Manage 1987; 2(1): 19–21

    PubMed  CAS  Google Scholar 

  16. Henrich W Autonomic insufficiency. Arch Intern Med 1992; 142: 339–44

    Google Scholar 

  17. Ewing D, Campbell I, Clarke B. Assessment of cardiovascular effects in diabetic autonomic neuropathy and prognostic implications. Ann Intern Med 1980; 92: 308–11

    PubMed  CAS  Google Scholar 

  18. Pereira J, Bruera E. Chronic nausea. In: Bruera E, Higginson I, editors. Cachexia-anorexia in cancer patients. Oxford: Oxford University Press, 1996: 23–37

    Google Scholar 

  19. Bruera E, MacEachern T, Spachynski K, et al. Comparison of the efficacy, safety and pharmacokinetics of controlled release and immediate release metoclopramide for the management of chronic nausea in patients with advanced cancer. Cancer 1994; 74(12): 3204–11

    PubMed  CAS  Google Scholar 

  20. Bruera E, Brenneis C, MacDonald RN, et al. Metoclopramide infusion with a disposable portable pump. Ann Intern Med 1986; 104: 896–7

    PubMed  CAS  Google Scholar 

  21. Shivshanker K, Bennett Jr RW, Haynie TP. Tumor-associated gastroparesis: correction with metoclopramide. Am J Surg 1983; 145(2): 221–5

    PubMed  CAS  Google Scholar 

  22. Gralla RJ, Itri LM, Pisko SE, et al. Antiemetic efficacy of high-dose metoclopramide: randomized trials with placebo and prochlorperazine in patients with chemotherapy-induced nausea and vomiting. N Engl J Med 1981; 305: 905–9

    PubMed  CAS  Google Scholar 

  23. Moertel C, Schutt AG, Reiteneier RJ, et al. Corticosteroid therapy of pre-terminal gastrointestinal cancer. Cancer 1974; 33: 1607–9

    PubMed  CAS  Google Scholar 

  24. Willox J, Corr J, Shaw J, et al. Prednisolone as an appetite stimulant in patients with cancer. BMJ 1984; 288(6410): 27

    PubMed  CAS  Google Scholar 

  25. Bruera E, Roca E, Cedaro L, et al. Action of oral methylprednisolone in terminal cancer patients: a prospective randomized double-blind study. Cancer Treat Rep 1985; 69(7/8): 751–4

    PubMed  CAS  Google Scholar 

  26. Robustelli Delia Cuna G, Pellegrini A, Piazzi M. Effect of methylprednisolone sodium succinate on quality of life in pre-terminal cancer patients: a placebo controlled multi-center study. Eur J Cancer Clin Oncol 1989; 25: 1823–9

    Google Scholar 

  27. Popiela T, Lucchi R, Giongo F. Methylprednisolone as palliative therapy for female terminal cancer patients. Eur J Cancer Clin Oncol 1989; 25: 1823–9

    PubMed  CAS  Google Scholar 

  28. Bruera E, Roca E, Cedaro L, et al. Improved control of chemotherapy-induced emesis by the addition of dexamethasone to metoclopramide in patients resistant to metoclopramide. Cancer Treat Rep 1983; 67(4): 381–3

    PubMed  CAS  Google Scholar 

  29. Watanabe S, Bruera E. Corticosteroids as adjuvant analgesics. J Pain Symptom Manage 1994; 9(7): 442–5

    PubMed  CAS  Google Scholar 

  30. Fainsinger R. Pharmacological approach to cancer anorexia and cachexia. In: Bruera E, Higginson I, editors. Cachexiaanorexia in cancer patients. Oxford: Oxford University Press 1996: 128–40

    Google Scholar 

  31. Plata-Salaman CR. Dexamethasone inhabits food intake suppression induced by low doses of interleukin-1B administered intracerebroventricularly. Brain Res Bull 1991; 27: 737–8

    PubMed  CAS  Google Scholar 

  32. Uchara A, Sekiya C, Takasugi Y, et al. Anorexia induced by interleukin 1: involvement of corticotropin-releasing factor [abstract]. Am J Physiol 1989; 257: R613–7

    Google Scholar 

  33. Hanks GW, Trueman T, Twycross RG. Corticosteroids in terminal cancer — a prospective analysis of current practice. Postgrad Med J 1983; 59: 702–6

    PubMed  CAS  Google Scholar 

  34. Needham PR, Daley AG, Lennard RF. Steroids in advanced cancer: survey of current practice. BMJ 1992; 305: 999

    PubMed  CAS  Google Scholar 

  35. Twycross RG. Corticosteroids in advanced cancer. BMJ 1992; 305: 969–70

    PubMed  CAS  Google Scholar 

  36. MacDonald SM, Hagen N, Bruera E. Proximal muscle weakness in a patient with hepatocellular carcinoma. J Pain Symptom Manage 1994; 9(5): 346–50

    PubMed  CAS  Google Scholar 

  37. Ettinger AB, Portenoy RK. The use of corticosteroids in the treatment of symptoms associated with cancer. J Pain Symptom Manage 1988; 3: 99–103

    PubMed  CAS  Google Scholar 

  38. Far WC. The use of corticosteroids for symptom management in terminally ill patients. Am J Hospice Care 1990; 1: 41–6

    Google Scholar 

  39. Williams CN. New steroids. Can J Gastroenterol 1993; 7: 588

    Google Scholar 

  40. Cavalli F, Goldhirsch A, Young IF. Randomized trial of low vs high dose medroxyprogesterone acetate in the treatment of postmenopausal patients with advanced breast cancer. In: Pellegrini A, Robustelli G, editors. Role of medroxyprogesterone in endocrine-related tumors. New York: Raven Press 1983; 69–76

    Google Scholar 

  41. Tchekmedyian S, Tait N, Moody M, et al. High dose megestrol acetate; a possible treatment of cachexia. J Am Med Assoc 1987; 257: 1195–9

    CAS  Google Scholar 

  42. Tchekmedyian S, Tait N, Moody M, et al. Appetite stimulation with megestrol acetate in cachectic cancer patients. Semin Oncol 1986; 13: 37–43

    PubMed  CAS  Google Scholar 

  43. Cruz JM, Muss HB, Brockschmidt JK, et al. Weight changes in woman with metastatic breast cancer treated with megestrol acetate: a comparison of standard vs a high dose therapy. Seminars Oncol 1990; 17 Suppl.: 63–7

    CAS  Google Scholar 

  44. Bruera E, Macmillan K, Hanson J, et al. A controlled trial of megestrol acetate on appetite, caloric intake, nutritional status, and other symptoms in patients with advanced cancer. Cancer 1990; 66: 1279–82

    PubMed  CAS  Google Scholar 

  45. Loprinzi CL, Ellison NM, Schaid DJ, et al. Controlled trial of megestrol acetate for the treatment of cancer, anorexia and cachexia. J Natl Cancer Inst 1990; 82: 1127–32

    PubMed  CAS  Google Scholar 

  46. Tchekmedyian S, Hakman M, Siau J, et al. Megestrol acetate in cancer anorexia and weight loss. Cancer 1992; 69: 1268–74

    PubMed  CAS  Google Scholar 

  47. Schmoll E, Wilke H, Thole R. Megestrol acetate in cancer cachexia. Seminars Oncol 1991; 1 Suppl. 2: 32–4

    Google Scholar 

  48. Heckmayr M, Gatzeneier U. Treatment of cancer weight loss in patients with advanced lung cancer. Oncology 1992; 49 Suppl. 2: 32–4

    Google Scholar 

  49. Feliu J, Gonzalez-Baron M, Berrocal A. Usefulness of megestrol acetate in cancer cachexia and anorexia. Am J Clin Oncol 1992; 15: 436–40

    PubMed  CAS  Google Scholar 

  50. Loprinzi CL, Michalak JC, Schaid DJ. Phase three evaluation of four doses of megestrol acetate as therapy for patients with cancer anorexia and/or cachexia. J Clin Oncol 1993; 11: 762–7

    PubMed  CAS  Google Scholar 

  51. Azcona C, Castro L, Crespo E, et al. Megestrol acetate therapy for anorexia and weight loss in children with malignant solid tumours. Aliment Pharmacol Ther 1996; 10: 577–86

    PubMed  CAS  Google Scholar 

  52. Belier E, Tattersall M, Lumley T, et al. Improved quality of life with megestrol acetate in patients with endocrine-insensitive advanced cancer: a randomised placebo-controlled trial. Ann Oncol 1997; 8: 277–83

    Google Scholar 

  53. Bruera E, Ernst S, Hagen N, et al. Symptomatic effects of megestrol acetate (MA): a double-blind, crossover study [abstract]. Proc ASCO No.1716 1996) 531

  54. Fietkau R, Riepl M, Kettner H. Supportive use of megestrol acetate in patients with head and neck cancer during radio(chemo) therapy. Eur J Cancer 1997; 33(1): 75–9

    PubMed  CAS  Google Scholar 

  55. McMillan DC, Simpson JM, Preston T, et al. Effect of megestrol acetate on weight loss, body composition and blood screen of gastrointestinal cancer patients. Clinical Nutr 1994; 85–9

  56. Gebbia V, Testa A, Gebbia N. Prospective randomised trial of two dose levels of megestrol acetate in the management of anorexia-cachexia syndrome in patients with metastatic cancer. Br J Cancer 1996; 73: 1576–80

    PubMed  CAS  Google Scholar 

  57. Downer S, Joel S, Allbright A, et al. A double blind placebo controlled trial of medroxyprogesterone acetate (MPA) in cancer cachexia. Br J Cancer 1993; 67(5): 1102–5

    PubMed  CAS  Google Scholar 

  58. Simons J, Aaronson NK, Vansteenkiste JF, et al. Effects of medroxyprogesterone acetate on appetite, weight, and quality of life in advanced-stage non-hormone-sensitive cancer: a placebo-controlled multicenter study. J Clin Oncol 1996; 14(4): 1077–84

    PubMed  CAS  Google Scholar 

  59. Lelli G, Angelelli B, Giambiasi ME, et al. The anabolic effect of high dose medroxyprogesterone acetate in oncology. Pharmacol Res Commun 1983; 15(6): 561–8

    PubMed  CAS  Google Scholar 

  60. Loprinzi CL, Schaid DJ, Dose AN, et al. Body-composition changes in patients who gain weight while receiving megestrol acetate. J Clin Oncol 1993; 11: 152–4

    PubMed  CAS  Google Scholar 

  61. Oster MH, Enders SR, Samuels SJ, et al. Megestrol acetate in patients with AIDS and cachexia. Ann Intern Med 1994; 121: 400–8

    PubMed  CAS  Google Scholar 

  62. Kornblith AB, Hollis DR, Zuckerman E, et al. Effect of megestrol acetate on quality of life in a dose-response trial in women with advanced breast cancer. J Clin Oncol 1993; 11: 2081–9

    PubMed  CAS  Google Scholar 

  63. Loprinzi CL, Kugler J, Sloan J, et al. Phase III randomized comparison of megestrol acetate, dexamethasone, and fluoxymesterone for the treatment of cancer anorexia/cachexia [abstract]. Proceed of ASCO 1997; 16: 48a

    Google Scholar 

  64. McCarthy WD, Crowder RE, Dryden S, et al. Megestrol acetate stimulates food and water intake in the rat: effects on regional hypothalamic neuropride Y concentrations. Eur J Pharmacol 1994; 265: 99–102

    PubMed  CAS  Google Scholar 

  65. Costa A-MIN, Spence KT, Plata-Salaman CR, et al. Megestrol acetate modulates the residual calcium channel current via the G-protein ∝2 subunit in acutely isolated rat ventromedial hypothalamic neurones. J Physiol (Lond) 1995; 487: 291–303

    CAS  Google Scholar 

  66. Mantovani G, Maccio A, Esu S, et al. Medroxprogesterone acetate reduces the production of cytokines and serotonin involved in anorexia/cachexia and emesis by peripheral blood mononuclear cells of cancer patients [abstract]. Biochem Soc Trans 1997; 25(2): 296S

    Google Scholar 

  67. De Vita Jr VT, Hellman S, Rosenberg SA, editors. Cancer principles and practice of oncology. Vol. 1, 5th ed. Philadelphia: Lippincott-Raven Publishers, 1997

    Google Scholar 

  68. Bruera E, Fainsinger RL. Clinical management of cachexia and anorexia. In: Doyle D, Hanks G, MacDonald N, editors. Oxford textbook of palliative medicine. London: Oxford Medical Publications, 1993: 330–7

    Google Scholar 

  69. Steer KA, Kurtz AB, Honour JW. Megestrol-induced Cushing’s syndrome. Clin Endocrinol 1995; 42: 91–3

    CAS  Google Scholar 

  70. Leinung MC, Liporace R, Miller CH. Introduction of adrenal suppression by megestrol acetate in patients with AIDS. Ann Intern Med 1995; 122: 843–5

    PubMed  CAS  Google Scholar 

  71. Rowland KM, Loprinzi CL, Shaw EG, et al. Randomised double-blind placebo-controlled trial of cisplatin and etoposide plus megestrol acetate/placebo in extensive stage small cell lung cancer: a North Central Cancer Treatment Group study. J Clin Oncol 1996; 14: 135–141

    PubMed  CAS  Google Scholar 

  72. Chlebowski RT, Bulcavate L, Grosvenor M, et al. Hydrazine sulfate influence on nutritional status and survival in non small cell lung cancer. J Clin Oncol 1990; 8: 9–15

    PubMed  CAS  Google Scholar 

  73. SilversteinR,BhatiaP,Svoboda DS. Effect of hydrazine sulfate on glucose-regulating enzymes in the normal and cancerous rat. Immunopharmacology 1989; 17: 37–43

    PubMed  CAS  Google Scholar 

  74. Tayek JA, Heber D, Chlebowski RT. Effect of hydrazine sulfate on whole body protein breakdown measured by C-lysine metabolism in lung cancer patients. Lancet 1987; II: 241–4

    Google Scholar 

  75. Chlebowski RT, Bulcavate L, Grosvenor M, et al. Hydrazine sulfate in cancer patients with weight loss: a placebo controlled clinical experience. Cancer 1987; 59: 406–10

    PubMed  CAS  Google Scholar 

  76. Loprinzi CL, Juross SA, O’Fallon JR, et al. Randomized, placebo-controlled evaluation on hydrazine sulfate in patients with advanced colorectal cancer. J Clin Oncol 1994; 12: 1121–5

    PubMed  CAS  Google Scholar 

  77. Loprinzi CL, Goldberg RM, Su JQ. Placebo-controlled trial of hydrazine sulfate in patients with newly diagnosed nonsmall-cell lung cancer. J Clin Oncol 1994; 12: 1126–9

    PubMed  CAS  Google Scholar 

  78. Kosty MP, Fleishman SB, Herndon JE, et al. Cisplatin, vinblas-tine and hydrazine sulfate in advanced non-small-cell lung cancer; a randomized placebo-controlled, double-blind phase HI study of the cancer and leukemia group B. J Clin Oncol 1994; 12: 1113–20

    PubMed  CAS  Google Scholar 

  79. Kardinal C, Loprinzi CL, Schaid DJ, et al. A controlled trial of cyproheptadine in cancer patients with anorexia and/or cachexia. Cancer 1990; 65: 2657–62

    PubMed  CAS  Google Scholar 

  80. Goldberg RM, Loprinzi CL, Mailliard JA, et al. Pentoxifylline for treatment of cancer anorexia and cachexia? A randomized, double-blind, placebo-controlled trial. J Clin Oncol 1995; 13(11): 2856–9

    PubMed  CAS  Google Scholar 

  81. Wadleigh R, Spaulding M, Lembersky B, et al. Dronabinol enhancement of appetite and cancer patients [abstract]. Proc Am Soc Oncol 1990; 9: 331

    Google Scholar 

  82. Nelson K, Walsh D, Deeter P, et al. Aphase II study of delta-nine tetrahydrocannabinol for appetite stimulation in cancer-associated anorexia. J Palliat Care 1994; 10: 14–8

    PubMed  CAS  Google Scholar 

  83. Wigmore SJ, Ross JA, Falconer JS, et al. The effect of polyun-saturated fatty acids on the progress of cachexia in patients with pancreatic cancer. Nutrition 1996; 12 (1 Suppl.): S27-30

    Google Scholar 

  84. Schmidt H, Rush B, Simonian G, et al. Thalidomide inhibits TNF response and increases survival following endotoxin injection in rats. J Surg Res 1996; 63(1): 143–6

    PubMed  CAS  Google Scholar 

  85. Schuler U, Ehninger G. Thalidomide: rationale for renewed use in immunological disorders. Drug Saf 1995; 12(6): 364–9

    PubMed  CAS  Google Scholar 

  86. Tramontana JM, Utaipat U, Molloy A, et al. Thalidomide treatment reduces tumor necrosis factor alpha production and enhances weight gain in patients with pulmonary tuberculosis. Mol Med 1995; 1(4): 384–97

    PubMed  CAS  Google Scholar 

  87. Kaplan G. Cytokine regulation of disease progression in leprosy and tuberculosis. Immunobiol 1994; 191(4–5): 564–8

    CAS  Google Scholar 

  88. Alexander LN, Wilcox CM. A prospective trial of thalidomide for the treatment of HTV-associated idiopathic esophageal ulcers. AIDS Res Hum Retroviruses 1997; 13(4): 301–4

    PubMed  CAS  Google Scholar 

  89. Jacobson JM, Greenspan JS, Spritzler J, et al. Thalidomide for the treatment of oral aphthous ulcers in patients with human immunodeficiency virus infection: National Institute of Allergy and Infectious Diseases AIDS Clinical Trials Group. N Engl J Med 1997; 336(21): 487–93

    Google Scholar 

  90. Stevens RJ, Andujar C, Edwards CJ, et al. Thalidomide in the treatment of the cutaneous manifestations of lupus erythematosus: experience in sixteen consecutive patients. Br J Rheumatol 1997; 36(3): 353–9

    PubMed  CAS  Google Scholar 

  91. Bonnetblanc JM, Royer C, Bedane C. Thalidomide and recurrent aphthous stomatitis: a follow-up study. Dermatology 1996; 193(4): 321–3

    PubMed  CAS  Google Scholar 

  92. Sharpstone D, Rowbottom A, Francis N, et al. Thalidomide: a novel therapy for microsporidiosis. Gastroenterology 1997; 112(6): 1823–9

    PubMed  CAS  Google Scholar 

  93. Reyes-Teran G, Sierra-Madero JG, Martinez del Cerro V, et al. Effects of thalidomide on HIV-associated wasting syndrome: a randomized, double-blind, placebo-controlled clinical trial. AIDS 1996; 10(13): 1501–7

    PubMed  CAS  Google Scholar 

  94. Klausner JD, Makonkawkeyoon S, Akarasewi P, et al. The effect of thalidomide on the pathogenesis of human immunodeficiency virus type 1 and M tuberculosis infection. J Acquir Immun Defic Syndr Hum Retrovirol 1996; 11(3): 247–57

    CAS  Google Scholar 

  95. Haslett P, Tramontant J, Burroughs M, et al. Adverse reactions to thalidomide in patients infected with human immunodeficiency virus. Clin Infect Dis 1997; 24(6): 1223–7

    PubMed  CAS  Google Scholar 

  96. Lissoni P, Barni S, Tancini G. Role of the pineal gland in the control of macrophage functions and its possible implication in cancer: a study of interactions between tumor necrosis factor-alpha and the pineal hormone melatonin. J Biol Regul Homest Agents 1994; 8(4): 126–9

    CAS  Google Scholar 

  97. Lissoni P, Barni S, Brivio F, et al. Treatment of cancer-related thrombocytopenia by low-dose subcutaneous interleukin-2 plus the pineal hormone melatonin: a biological phase II study. J Biol Regul Homeost Agents 1995; 9(2): 52–4

    PubMed  CAS  Google Scholar 

  98. Lissoni P, Paolorossi F, Tancini G, et al. Is there a role for melatonin in the treatment of neoplastic cachexia? Eur J Cancer 1996; 32A(8): 1340–3

    PubMed  CAS  Google Scholar 

  99. Lissoni P, Brivio F, Ardizzoia A, et al. Subcutaneous therapy with low-dose interleukin-2 plus the neurohormone melatonin in metastatic gastric cancer patients with low performance status. Tumori 1993; 79(6): 401–4

    PubMed  CAS  Google Scholar 

  100. Costelli P, Garcia-Martinez C, Llovera M, et al. Muscle protein waste in tumor-bearing rats is effectively antagonized by a beta 2-adrenergic agonist (clenbuterol): role of the ATP-ubiquitin-dependent proteolytic pathway. J Clin Invest 1995; 95(5): 2367–72

    PubMed  CAS  Google Scholar 

  101. Chance WT, Cao LQ, Zhang FS, et al. Clenbuterol treatment increases muscle mass and protein content of tumor-bearing rats maintained on total parenteral nutrition. J Parenter Enter Nutr 1991; 15(5): 530–5

    CAS  Google Scholar 

  102. Rehfeldt C, Weikard R, Reichel K. The effect of the beta-adrenergic agonist clenbuterol on the growth of skeletal muscles of rats. Archiv Tierernahr 1994; 45(4): 333–44

    CAS  Google Scholar 

  103. Young OA, Watkins S, Oldham JM. The role of insulin-like growth factor I in clenbuterol-stimulated growth in growing lambs. J Anim Sci 1995; 73(10): 3069–77

    PubMed  CAS  Google Scholar 

  104. Zhou GH, Han ZK. Effects of dietary supplementation of beta 2-adrenergic agonist clenbuterol on carcase characteristics and some metabolites in ducks. Br Poultry Sci 1994; 35(3): 355–61

    CAS  Google Scholar 

  105. Carbo N, Lopez-Soriano J, Tarrago T, et al. Comparative effects of beta2-adrenergic agonists on muscle waste associated with tumour growth. Cancer Lett 1997; 115(1): 113–8

    PubMed  CAS  Google Scholar 

  106. Maltin CA, Delday MI, Watson JS, et al. Clenbuterol, a beta-adrenoceptor agonist, increases relative muscle strength in orthopaedic patients. Clin Sci 1993; 84(6): 651–4

    PubMed  CAS  Google Scholar 

  107. Salleras L, Dominguez A, Mata E, et al. Epidemiologic study of an outbreak of clenbuterol poisoning in Catalonia, Spain. Public Health Rep 1995; 110(3): 338–42

    PubMed  CAS  Google Scholar 

  108. Dezube BJ, Sherman ML, Fridovich-Keil JL, et al. Down-regulation of tumor necrosis factor expression by pentoxifylline in cancer patients: a pilot study. Cancer Immunol Immunother 1993; 36(1): 57–60

    PubMed  CAS  Google Scholar 

  109. Lissoni P, Ardizzoia A, Barni S, et al. Characterization of cancer-related disseminated intravascular coagulation in relation to tumor necrosis factor-alpha blood concentrations: possible therapeutic role of pentoxifylline. Tumori 1996; 82(1): 78–80

    PubMed  CAS  Google Scholar 

  110. Ardizzoia A, Lissoni P, Tancini G, et al. Respiratory distress syndrome in patients with advanced cancer treated with pentoxifylline: a randomized study. Suppl Care Cancer 1993; 1(6): 331–3

    CAS  Google Scholar 

  111. Lissoni P, Ardizzoia A, Perego MS, et al. Inhibition of tumor necrosis factor-alpha secretion by pentoxifylline in advanced cancer patients with abnormally high blood levels of tumor necrosis factor-alpha. J Biol Regul Homeost Agents 1993; 7(2): 73–5

    PubMed  CAS  Google Scholar 

  112. Forbes GB. The effect of anabolic steroids on lean body mass: the dose response curve. Metabolism 1985; 34(6): 571–3

    PubMed  CAS  Google Scholar 

  113. Hengge UR, Baumann M, Maleba R, et al. Oxymetholone promotes weight gain in patients with advanced human immunodeficiency virus (HrV-1) infection. Br J Nutr 1996; 75(1): 129–38

    PubMed  CAS  Google Scholar 

  114. Foltin RW, Fischman MW, Byrne MF. Effects of smoked marijuana on food intake an body weight of humans living in a residential laboratory. Appetite 1988; 11: 1–14

    PubMed  CAS  Google Scholar 

  115. Mechoulam R, McCallum NK, Lander V et al. Aspects of cannabis chemistry and metabolism. In: Braude MC, Szara S, editors. The pharmacology of marijuana. New York: Raven Press, 1976: 39–48

    Google Scholar 

  116. Frytak S, Moertel CJ, O’Fallon JR, et al. Delta-nine-tetrahydro-cannabinol as an antiemetic for patients receiving cancer chemotherapy. Ann Intern Med 1979; 91: 825–30

    PubMed  CAS  Google Scholar 

  117. Lucas VS, Laszio J. Delta-nine-tetrahydrocannabinol for refractory vomiting induced by cancer chemotherapy. JAMA 1980; 243: 1241–3

    PubMed  Google Scholar 

  118. Underleider JT, Andrysiak T, Fairbanks L, et al. Cannabis in cancer chemotherapy. Cancer 1992; 50: 635–6

    Google Scholar 

  119. Lane M, Vogel CL, Ferguson J, et al. Dronabinol and pro-chlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting. J Pain Symptom Manage 1991; 6: 352–9

    PubMed  CAS  Google Scholar 

  120. Beal JE, Olson R, Laubenstein L, et al. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. J Pain Symptom Manage 1995; 10(2): 89–97

    PubMed  CAS  Google Scholar 

  121. Fainsinger RL, Tapper M, Bruera E. A perspective on the management of delirium in the terminally ill. J Palliat Care 1993; 9(3): 4–8

    PubMed  CAS  Google Scholar 

  122. Gelin J, Moldawer LL, Lonnroth C, et al. Role of endogenous tumor necrosis factor α and interleukin-1 for experimental tumor growth and the development of cancer cachexia. Cancer Res 1991; 51: 415–21

    PubMed  CAS  Google Scholar 

  123. Marnett LJ. Polycyclic aromatic hydrocarbon oxidation during prostaglandin biosynthesis. Life Sci 1981; 29: 531–46

    PubMed  CAS  Google Scholar 

  124. Cariuk P, Lorite MJ, Todorov PT, et al. Induction of cachexia in mice by a product isolated from the urine of cachectic cancer patients. Br J Cancer 1997; 76(5): 606–13

    PubMed  CAS  Google Scholar 

  125. McMillan DC, Leen E, Smith J, et al. Effect of extended ibuprofen administered on the acute phase protein response in colorectal cancer patients. Eur J Surg Oncol 1995; 21: 531–4

    PubMed  CAS  Google Scholar 

  126. Preston T, Fearon KCH, McMillan DC, et al. Effect of ibuprofen on the acute-phase response and protein metabolism in patients with cancer and weight loss. Br J Surg 1995; 82: 229–34

    PubMed  CAS  Google Scholar 

  127. Wigmore SJ, Falconer JS, Plester CE, et al. Ibuprofen reduces energy expenditure and acute-phase protein production compared with placebo in pancreatic cancer patients. Br J Cancer 1995; 72(1): 185–8

    PubMed  CAS  Google Scholar 

  128. McMillan DC, O’Gorman P, Fearon KCH, et al. A pilot study of megestrol acetate and ibuprofen in the treatment of cachexia in gastrointestinal cancer patients. Br J Cancer 1997; 76(6): 788–90

    PubMed  CAS  Google Scholar 

  129. Lundholm K, Gelin J, Hyltander A, et al. Anti-inflammatory treatment may prolong survival in undernourished patients with metastatic solid tumors. Cancer Research 1994; 54: 5602–6

    PubMed  CAS  Google Scholar 

  130. Tisdale MJ. Inhibition of lipolysis and muscle protein degradation by EPA in cancer cachexia. Nutrition 1996; 12 (1 Suppl.): S31–3

    PubMed  CAS  Google Scholar 

  131. Schloss I, Kidd MS, Tichelaar HY, et al. Dietary factors associated with a low risk of colon cancer in coloured west coast fisherman. S Afr Med J 1997; 87(2): 152–8

    PubMed  CAS  Google Scholar 

  132. Cave Jr WT. Dietary omega-3 polyunsaturated fats and breast cancer. Nutrition 1996; 12 (1 Suppl.): S39–42

    PubMed  Google Scholar 

  133. Wigmore SJ, Fearon KC, Maingay JP, et al. Down-regulation of the acute-phase response in patients with pancreatic cancer cachexia receiving oral eicosapentaenoic acid is mediated via suppression of interleukin-6. Clin Sci 1997; 92(2): 215–21

    PubMed  CAS  Google Scholar 

  134. Ohira T, Nishio K, Ohe Y, et al. Improvement by eicosanoids in cancer cachexia induced by LLC-IL6 transplantation. J Cancer Res Clin Oncol 1996; 122(12): 711–5

    PubMed  CAS  Google Scholar 

  135. Warr D. Standard treatment of chemotherapy-induced emesis. Support Care Cancer 1997; 5: 12–6

    PubMed  CAS  Google Scholar 

  136. Levy MH. Pharmacologic treatment of cancer pain. N Engl J Med 1996; 335(15): 1124–32

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Canada

    Bruno Gagnon &  Eduardo Bruera (Director)

Authors
  1. Bruno Gagnon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eduardo Bruera
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gagnon, B., Bruera, E. A Review of the Drug Treatment of Cachexia Associated with Cancer. Drugs 55, 675–688 (1998). https://doi.org/10.2165/00003495-199855050-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-199855050-00005

Keywords

Search

Navigation