Cancer cachexia: understanding the molecular basis

Cancer cachexia is a multifactorial syndrome that affects many cancer patients and that leads to substantial weight loss, primarily from loss of skeletal muscle and body fat. This Opinion article focuses on the molecular mechanisms underlying cancer cachexia, in hopes that a better understanding of these might lead to improved therapeutic approaches. Cancer cachexia is a devastating, multifactorial and often irreversible syndrome that affects around 50–80% of cancer patients, depending on the tumour type, and that leads to substantial weight loss, primarily from loss of skeletal muscle and body fat. Since cachexia may account for up to 20% of cancer deaths, understanding the underlying molecular mechanisms is essential. The occurrence of cachexia in cancer patients is dependent on the patient response to tumour progression, including the activation of the inflammatory response and energetic inefficiency involving the mitochondria. Interestingly, crosstalk between different cell types ultimately seems to result in muscle wasting. Some of the recent progress in understanding the molecular mechanisms of cachexia may lead to new therapeutic approaches.