Abstract: When malignant tumors develop to the late stage, cancer cachexia (CC) is one of the most common complications. Its clinical symptoms are generally manifested as a decrease in muscle and bone mass, or a decrease in fat content, loss of appetite, and metabolic disorders, which lead to organ dysfunction. The study found that about one fifth of malignant tumor patients died from CC. The occurrence of CC has a serious impact on patients'lives, increasing treatment time, improving treatment cost, decreasing quality of life and reducing survival time. The pathogenesis of CC is complex. The known pathogenesis includes irreversible chronic inflammation induced by long-term stimulation of tumor tissue, the influence of inflammatory reaction on human metabolic balance, the inhibition of secretion of beneficial substances in central nervous system by inflammatory factors, and the reduction of appetite signals. At the present stage, some research results have been obtained on the pathogenesis of this disease. With the deepening of the research, we have a certain understanding of its therapeutic drugs. In view of its pathogenesis, the treatment of CC requires a variety of channels to work together, to give patients adequate nutrition and drug combination. This article from the current use of more appetite-stimulating drugs (progesterone, gastrin), anti-inflammatory drugs (non-steroidal anti-inflammatory drugs, thalidomide, omega-3 fatty acids), protein degradation inhibitors, metabolic regulators (androgen receptor regulators, beta-receptor blockers)analyzes the effect of the medication, and on the research progress of drug combination therapy is discussed.
王超云,杜成,关欣,杜晓薇,徐竹轩,郑振东. 肿瘤恶液质的药物治疗研究进展[J]. 肿瘤代谢与营养电子杂志, 2019, 6(3): 382-385.
WANG Chao-yun, DU Cheng, GUAN Xin, DU Xiao-wei, XU Zhu-xuan, ZHENG Zhen-dong. Advances in drug therapy for cancer cachexia. Electron J Metab Nutr Cancer, 2019, 6(3): 382-385.
1.吴晓东, 王春华, 李丽梅,等. 癌症恶病质药物治疗模式的研究. 宁夏医学杂志. 2017;39(8):730-732.
2.王芳, 栾晓, 郭菲菲. Ghrelin及其类似物BIM-28131、BIM-28125对大鼠心衰模型肌肉生长抑制素表达的影响.现代生物医学进展. 2015;15(7):1233-1236,1303.
3.陈福欣, 文和, 龚频. 生长激素释放肽在恶病质中的应用研究进展. 中国药房. 2016;27(35):5028-5030.
4.张蕴超, 贾英杰, 朱津丽,等. 消岩汤联合榄香烯注射液治疗癌症恶病质41例临床观察. 中医杂志. 2016;57(7):574-578.
5.张影, 冯少华, 林敏. 癌症恶病质患者行健脾化痰汤治疗的疗效分析. 中国保健营养. 2016;26(24):344.
6.汪立鑫, 周岩冰. 癌性恶病质肌肉减少的病理生理机制和治疗方法. 中华临床营养杂志. 2016;24(3):179-185.
7.黄景东, 陈文真. 参附注射液治疗消化道肿瘤晚期恶病质的疗效观察. 光明中医. 2016;31(3):374-376.
8.梁华兵, 吴玉清, 梁玲琪. 癌症恶病质贫血患者血象和骨髓象特征分析. 临床检验杂志. 2016;34(4):281-283.
9.Madeddu C, Mantovani G, Gramignano G, et al. Advances in pharmacologic strategies for cancer cachexia. Expert Opin Pharmacother. 2015;16(14):2163-2177.
10.Shirai Y, Okugawa Y, Hishida A, et al. Fish oil-enriched nutrition combined with systemic chemotherapy for gastrointestinal cancer patients with cancer cachexia. Sci Rep. 2017;7(1):4826.
11.Kang X, Xiao HH, Song HQ, et al. Advances in drug delivery system for platinum agents based combination therapy. Cancer Biol Med. 2015;12(4):362-374.
12.Pretto F, Ghilardi C, Moschetta M, et al. Sunitinib prevents cachexia and prolongs survival of mice bearing renal cancer by restraining STAT3 and MuRF-1 activation in muscle. Oncotarget. 2015;6(5):3043-3054.
13.Takayama K, Atagi S, Imamura F, et al. Quality of life and survival survey of cancer cachexia in advanced non-small cell lung cancer patients—Japan nutrition and QOL survey in patients with advanced non-small cell lung cancer study. Support Care Cancer. 2016;24(8):3473-3480.
14.Sun L, Quan X Q, Yu S. et al. An epidemiological survey of cachexia in advanced cancer patients and analysis on its diagnostic and treatment status. Nutr Cancer. 2015;67(7):1056-1062.
15.Sadeghi M, Keshavarzfathi M, Baracos V, et al. Cancer cachexia: diagnosis, assessment, and treatment. Crit Rev Oncol Hematol. 2018;127(8):91-104.
16.Stewart Coast AJ, Ho GF, Prabhash K, et al. Espindolol for the treatment and prevention of cachexia in patients with stage III/IV non-small cell lung cancer or colorectal cancer: a randomized, double-blind, placebo-controlled, international multicentre phase II study (the ACT-ONE trial). J Cachexia Sarcopenia Muscle. 2016;7(3):355-365.
17.Aversa Z, Costelli P, Muscaritoli M.et al. Cancer-induced muscle wasting: latest findings in prevention and treatment. Ther Adv Med Oncol. 2017;9(5):369-382.
18.Bruggeman AR, Kamal AH, Leblanc TW, et al. Cancer cachexia: beyond weight loss. J Oncol Pract. 2016;12(11):1163-1171.
19.Garcia JM, Boccia RV, Graham CD, et al. Anamorelin for patients with cancer cachexia: an integrated analysis of two phase 2, randomised, placebo-controlled, double-blind trials. Lancet Oncol. 2015;16(1):108-116.
20.Mochamat, Cuhls H, Marinova M, et al. A systematic review on the role of vitamins, minerals, proteins, and other supplements for the treatment of cachexia in cancer: a European palliative care research centre cachexia project. J Cachexia Sarcopenia Muscle. 2017;8(1):25-39.
21.Naito T, Okayama T, Aoyama T, et al. Unfavorable impact of cancer cachexia on activity of daily living and need for inpatient care in elderly patients with advanced non-small-cell lung cancer in Japan: a prospective longitudinal observational study. Bmc Cancer. 2017;17:800.
22.Ishida J, Saitoh M, Springer J,et al. Single-nucleotide polymorphisms in cachexia-related genes: can they optimize the treatment of cancer cachexia? J Cachexia Sarcopenia Muscle. 2017;8(3):516-517.
23.Vigano AAL, Morais JA, Ciutto L, et al. Use of routinely available clinical, nutritional, and functional criteria to classify cachexia in advanced cancer patients. Clin Nutr. 2017;36(5):1378-1390.
24.Dev R, Hui D, Chisholm G, et al. Hypermetabolism and symptom burden in advanced cancer patients evaluated in a cachexia clinic. J Cachexia Sarcopenia Muscle. 2015;6(1):95-98.
25.Wang Q, Li C, Peng X, et al. Combined treatment of carfilzomib and z-VAD-fmk inhibits skeletal proteolysis and apoptosis and ameliorates cancer cachexia. Med Oncol. 2015;32(4):100.
26.Amano K, Morita T, Miyamoto J, et al. Perception of need for nutritional support in advanced cancer patients with cachexia: a survey in palliative care settings. Support Care Cancer. 2018;26(8):2793-2799.
27.Terawaki K, Kashiwase Y, Sawada Y, et al. Development of ghrelin resistance in a cancer cachexia rat model using human gastric cancer-derived 85As2 cells and the palliative effects of the Kampo medicine rikkunshito on the model. PLoS One. 2017;12(3):e0173113.
28.Cala MP, Agulló-Ortuo MT, Prieto-García E, et al. Multiplatform plasma fingerprinting in cancer cachexia: a pilot observational and translational study. J Cachexia Sarcopenia Muscle. 2018;9(2):348-357.
29.Currow D, Temel J S, Abernethy A, et al. ROMANA 3: a phase 3 safety extension study of anamorelin in advanced non-small cell lung cancer (NSCLC) patients with cachexia. Ann Oncol. 2017;28(8):1949-1956.