文章：

癌症恶病质研究进展：临床管理与药物干预策略

Updates in Cancer Cachexia: Clinical Management and Pharmacologic Interventions

原文发布日期：27 April 2024

DOI: 10.3390/cancers16091696

类型: Article

开放获取: 是

英文摘要：

Despite a better understanding of the mechanisms causing cancer cachexia (CC) and development of promising pharmacologic and supportive care interventions, CC persists as an underdiagnosed and undertreated condition. CC contributes to fatigue, poor quality of life, functional impairment, increases treatment related toxicity, and reduces survival. The core elements of CC such as weight loss and poor appetite should be identified early. Currently, addressing contributing conditions (hypothyroidism, hypogonadism, and adrenal insufficiency), managing nutrition impact symptoms leading to decreased oral intake (nausea, constipation, dysgeusia, stomatitis, mucositis, pain, fatigue, depressed mood, or anxiety), and the addition of pharmacologic agents when appropriate (progesterone analog, corticosteroids, and olanzapine) is recommended. In Japan, the clinical practice has changed based on the availability of Anamorelin, a ghrelin receptor agonist that improved lean body mass, weight, and appetite-related quality of life (QoL) compared to a placebo, in phase III trials. Other promising therapeutic agents currently in trials include Espindolol, a non-selective β blocker and a monoclonal antibody to GDF-15. In the future, a single therapeutic agent or perhaps multiple medications targeting the various mechanisms of CC may prove to be an effective strategy. Ideally, these medications should be incorporated into a multimodal interdisciplinary approach that includes exercise and nutrition.

摘要翻译： 

尽管对导致癌症恶液质（CC）的机制有了更深入的理解，并开发出有前景的药物和支持性护理干预措施，但CC仍然是一种诊断不足和治疗不足的病症。CC会导致疲劳、生活质量下降、功能受损，增加治疗相关毒性，并降低生存率。应及早识别CC的核心要素，如体重减轻和食欲不振。目前，建议的处理方法包括：处理相关病症（甲状腺功能减退、性腺功能减退和肾上腺功能不全），管理导致口服摄入减少的营养影响症状（恶心、便秘、味觉障碍、口炎、黏膜炎、疼痛、疲劳、情绪低落或焦虑），并在适当时添加药物（孕激素类似物、皮质类固醇和奥氮平）。在日本，基于阿那莫林的可用性，临床实践已经发生了变化。阿那莫林是一种生长激素促分泌素受体激动剂，在III期试验中，与安慰剂相比，它改善了瘦体重、体重和与食欲相关的生活质量（QoL）。目前正在试验中的其他有前景的治疗药物包括艾司吲哚（一种非选择性β受体阻滞剂）和针对GDF-15的单克隆抗体。未来，单一治疗药物或可能针对CC多种机制的多种药物可能被证明是一种有效的策略。理想情况下，这些药物应纳入包括运动和营养在内的多模式跨学科方法中。

原文链接：

Updates in Cancer Cachexia: Clinical Management and Pharmacologic Interventions