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Cancer anorexia/cachexia

  • Richard M. Goldberg
  • Charles L. Loprinzi
Chapter
Part of the Cancer Treatment and Research book series (CTAR, volume 100)

Abstract

This chapter will address a number of issues regarding cancer anorexia/ cachexia. These include (1) the significance of this clinical problem; (2) potential mechanisms that cause cancer anorexia/cachexia; (3) mechanisms for studying antidotes for cancer anorexia/cachexia; (4) clinical trials of potential drugs; and (5) current recommendations for the therapy of cancer anorexia/cachexia.

Keywords

Clin Oncol Anabolic Steroid Nandrolone Decanoate Hydrazine Sulfate Appetite Stimulant 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Shils ME. 1979. Principles of nutritional support. Cancer 43:2093–2102.PubMedCrossRefGoogle Scholar
  2. 2.
    Bruera E. 1992. Current pharmacologic management of anorexia in cancer patients. Oncology 6:125–130.PubMedGoogle Scholar
  3. 3.
    De Wys WD, Begg C, Lavin PT, et al. 1980. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med 69:491–497.CrossRefGoogle Scholar
  4. 4.
    Bruera E, MacDonald RN. 1988. Asthenia in patients with advanced cancer. J Pain Symptom Manage 3:9–14.PubMedCrossRefGoogle Scholar
  5. 5.
    Lowry SF, Moldawer LL. 1990. Tumor necrosis factor and other cytokines in the pathogenesis of cancer anorexia and cachexia. Princ Pract Oncol Updates 4(8):1–12.Google Scholar
  6. 6.
    Bozzett F, Pagnoni AM, Del Vecchio M. 1980. Excessive calorie expenditure as a cause of malnutrition in patients with cancer. Surg Gynecol Obstet 150:229–234.Google Scholar
  7. 7.
    Lundholm K, Bylund AC, Schersten T. 1977. Glucose tolerance in relation to skeletal muscle enzyme activities in cancer patients. Scand J Clin Lab Invest 37:2670–2672.CrossRefGoogle Scholar
  8. 8.
    Norton JA, Stein TP, Brennan M. 1980. Whole body protein turnover studies in normal humans and malnourished patients with and without cancer. Ann Surg 31:94–96.Google Scholar
  9. 9.
    Heber D, Cheblowki RT, Ishibashi DE, et al. 1982. Abnormalities in glucose and protein metabolism in noncachectic lung cancer patients. Cancer Res 42:4815–4819.PubMedGoogle Scholar
  10. 10.
    Schein PS, Kisner D, Haller D, et al. 1979. Cachexia of malignancy. Potential role of insulin in nutritional management. Cancer 43:2070–2076.Google Scholar
  11. 11.
    Cohn S, Gartenhaus W, Sawitsky A, et al. 1981 Compartmental composition of cancer patients by measurement of total body nitrogen, potassium, and water. Metabolism: Clinical and Experimental 30:222–229.CrossRefGoogle Scholar
  12. 12.
    Brennan M. 1981 Total parenteral nutrition and the cancer patient. N Engl J Med 305:375–382.PubMedCrossRefGoogle Scholar
  13. 13.
    Oliff A, Defeo-Jones D, Boyer M, et al. 1987. Tumors secreting human TNF/cachectin induce cachexia in mice. Cell 50:555–563.PubMedCrossRefGoogle Scholar
  14. 14.
    Feingold KR, Sould M, Stapraus I, et al. 1989. Effect of tumor necrosis factor TNF on lipid metabolism in the diabetic rat. Evidence that inhibition of adipose tissue lipoprotein lipase is not required for TNF-induced hyperlipidemia. J Clin Invest 83:1116–1121PubMedCrossRefGoogle Scholar
  15. 15.
    Strovroff MC, Fraker DI, Norton JA. 1989. Cachectin activity in the serum of cachectic tumor bearing rats. Arch Surg 124:94–99.CrossRefGoogle Scholar
  16. 16.
    Socher SH, Friedman A, Martinez D. 1988. Recombinant human tumor necrosis factor induces acute reductions in food intake and body weight in mice. J Exp Med 167:1957–1962.PubMedCrossRefGoogle Scholar
  17. 17.
    Loprinzi CL, Ellison NM, Schaid DJ, et al. 1990. Controlled trial of megestrol acetate for the treatment of cancer anorexia and cachexia. J Natl Cancer Inst 82:1127–1132.PubMedCrossRefGoogle Scholar
  18. 18.
    Kardinal CG, Loprinzi CL, Schaid DJ, et al. 1990. A controlled trial of cyproheptadine in cancer patients with anorexia and/or cachexia. Cancer 65:2657–2662.PubMedCrossRefGoogle Scholar
  19. 19.
    Loprinzi CL, Michalak JC, Schaid DJ, et al. 1993. Phase III evaluation of four doses of megestrol acetate as therapy for patients with cancer anorexia and/or cachexia. J Clin Oncol 11:762–767.PubMedGoogle Scholar
  20. 20.
    Bruera E, Macmillan K, Kuehn N, et al. 1990. A controlled trial of megestrol acetate on appetite, caloric intake, nutritional status, and other symptoms in patients with advanced cancer. Cancer 66:1279–1282.PubMedCrossRefGoogle Scholar
  21. 21.
    Feliu J, Gonzalez-Baron M, Berrocal A, et al. 1991 Treatment of cancer anorexia with megestrol acetate: which is the optimal dose? J Natl Cancer Inst 83:449.PubMedCrossRefGoogle Scholar
  22. 22.
    Tchekmedyian NS, Hickman M, Siau J, et al. 1992. Megestrol acetate in cancer anorexia and weight loss. Cancer 69:1268–1274.PubMedCrossRefGoogle Scholar
  23. 23.
    Moertel CG, Kvols LK, Rubin J. 1991 A study of cyproheptadine in the treatment of metastatic carcinoid tumor and the malignant carcinoid syndrome. Cancer 67:33–36.PubMedCrossRefGoogle Scholar
  24. 24.
    Lerner HJ, Regelson W. 1976. Clinical trial of hydrazine sulfate in solid tumors. Cancer Treat Rep 60:959–960.PubMedGoogle Scholar
  25. 25.
    Ochua M Jr, Wittes RE, Krakoss L. 1975. Trial of hydrazine sulfate (NSC-150014) in patients with cancer. Cancer Chemother Rep 59:1151–1153.Google Scholar
  26. 26.
    Spremulli E, Wampler GL, Regelson W. 1979. Clinical study of hydrazine sulfate in advanced cancer patients. Cancer Chemother Pharmacol 3:121–124.PubMedCrossRefGoogle Scholar
  27. 27.
    Gold J. 1975. Use of hydrazine sulfate in terminal and preterminal cancer patients: results of investigational new drug (IND) study in 84 evaluable patients. Oncology 32:1–10.PubMedCrossRefGoogle Scholar
  28. 28.
    Chelobwski RT, Heber D, Richardson B, et al. 1984. Influence of hydrazine sulfate on abnormal carbohydrate metabolism in cancer patients with weight loss. Cancer Res 44:857–861Google Scholar
  29. 29.
    Chleboski RT, Bulcavage L, Grosvenor M, et al. 1987. Hydrazine sulfate in cancer patients with weight loss. Cancer 59:406–410.CrossRefGoogle Scholar
  30. 30.
    Filov VA, Danova LA, Gershanovich ML, et al. 1990. Results of clinical evaluation of hydrazine sulfate. Vopr Onkol 36:721–726.PubMedGoogle Scholar
  31. 31.
    Chlebowski RT, Bulcavage L, Grosvenor M, et al. 1990. Hydrazine sulfate influence on nutritional status and survival in non-small cell lung cancer. J Clin Oncol 8:9–15.PubMedGoogle Scholar
  32. 32.
    Loprinzi CL, Goldberg RG, Su JOI, et al. 1994. Placebo-controlled trial of hydrazine sulfate in patients with newly diagnosed non-small cell lung cancer. J Clin Oncol 12:1126–1129.PubMedGoogle Scholar
  33. 33.
    Kosty MP, Fleishman SB, Herndon JE, et al. 1994. Cisplatin, vinblastine, and hydrazine sulfate in advanced, non-small-cell lung cancer: a randomized placebo-controlled, double-blind phase III study of the cancer and leukemia group B. J Clin Oncol 12(6):1113–1120.PubMedGoogle Scholar
  34. 34.
    Loprinzi CL, Kuross SA, O’Fallon JR, et al. 1994. Randomized placebo-controlled evaluation of hydrazine sulfate in patients with advanced colorectal cancer. J Clin Oncol 12:1121–1125.PubMedGoogle Scholar
  35. 35.
    Beal JE, Olson R, Laubenstein L, et al. 1995. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. J Pain Symptom Manage 10(2):89–97.PubMedCrossRefGoogle Scholar
  36. 36.
    Nelson K, Walsh D, Deeter P, Sheehan F. 1994. A phase II study of delta-9-tetrahydrocannabinol for appetite stimulation in cancer-associated anorexia. J Palliat Care 10(l):14–18.PubMedGoogle Scholar
  37. 37.
    Dezube BJ, Fridovbich-Keil JL, Bouvard I, et al. 1990. Pentoxifylline and wellbeing in patients with cancer. Lancet 1:335:662.Google Scholar
  38. 38.
    Goldberg RM, Loprinzi CL, Mailliard JA, et al. 1995. Pentoxifylline for treatment of cancer anorexia/cachexia? A randomized, double-blinded, placebo controlled trial. J Clin Oncol 13(11):2856–2859.PubMedGoogle Scholar
  39. 39.
    Freed DJ, Banks AJ, Longson D, Burley DM. 1975. Anabolic steroids in athletics: crossover double-blind trial on weightlifters. Br Med J 5:471–473.CrossRefGoogle Scholar
  40. 40.
    Chlebowski RT, Herrold J, Ali I, et al. 1986. Influence of nandrolone decanoate on weight loss in advanced non-small cell lung cancer. Cancer 58:183–186.PubMedCrossRefGoogle Scholar
  41. 41.
    Loprinzi CL, Kugler J, Sloan J, et al. 1997. Phase III randomized comparison of megestrol acetate dexamethasone and fluoxymesterone for the treatment of cancer anorexia/cachexia. Proc Am Soc Clin Oncol 16:48a.Google Scholar
  42. 42.
    Moertel CG, Schutt AJ, Reitemeier RJ, Hahn RG. 1974. Corticosteroid therapy of preterminal gastrointestinal cancer. Cancer 33:1607–1609.PubMedCrossRefGoogle Scholar
  43. 43.
    Bruera E, Roca E, Cedaro L, et al. 1985. Action of oral methylprednisolone in terminal cancer patients: a prospective randomized double-blind study. Cancer Treat Rep 69:751–754.PubMedGoogle Scholar
  44. 44.
    Popiela T, Lucchi R, Giongo F 1989. Methylprednisolone as palliative therapy for female terminal cancer patients. Eur J Cancer Clin Oncol 25:1823–1829.PubMedCrossRefGoogle Scholar
  45. 45.
    Wilcox J, Corr J, Shaw J, et al. 1984. Prednisolone as an appetite stimulant in patients with cancer. Br Med J 288:27.Google Scholar
  46. 46.
    Tchekmedyian NS, Hickman M, Siau J, et al. 1992. Megestrol acetate in cancer anorexia and weight loss. Cancer 69:1268–1274.PubMedCrossRefGoogle Scholar
  47. 47.
    Von Roenn JH, Armstrong D, Kotier DP, et al. 1994. Megestrol acetate in patients with AIDS-related cachexia. Ann Intern Med 121:393–399.Google Scholar
  48. 48.
    Oster MH, Enders SR, Samuels SJ, et al. 1994. Megestrol acetate in patients with AIDS and cachexia. Ann Intern Med 121:400–408.PubMedGoogle Scholar
  49. 49.
    Loprinzi CL. 1992. Effect of megestrol acetate on the human pituitary-adrenal axis. Mayo Clin Proc 67:1160–1162.PubMedGoogle Scholar
  50. 50.
    Leinung MC, Liporace R, Miller CH. 1995. Induction of adrenal suppression by megestrol acetate in patients with AIDS. Ann Intern Med 122:843–845.PubMedGoogle Scholar
  51. 51.
    Rowland KM Jr, Loprinzi CL, Shaw EG, et al. 1996. Randomized 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 14(1):135–141PubMedGoogle Scholar
  52. 52.
    Loprinzi CL, Schaid DJ, Dose AM, et al. 1993. Body-composition changes in patients who gain weight while receiving megestrol acetate. J Clin Oncol 11(1): 152–154.PubMedGoogle Scholar
  53. 53.
    Reitmeier M, Hartenstein RC. 1990. Megestrol acetate and determination of body composition by bioelectrical impedance analysis in cancer cachexia (abstract). Proc Am Soc Clin Oncol 9:325.Google Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Richard M. Goldberg
  • Charles L. Loprinzi

There are no affiliations available

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