Catabolic mediators as targets for cancer cachexia

The cachexia syndrome, characterized by a marked weight loss, anorexia, asthenia and anaemia, is invariably associated with the growth of a tumour and leads to a malnutrition status caused by the induction of anorexia or decreased food intake. In addition, the competition for nutrients between the tumour and the host results in an accelerated catabolism state, which promotes severe metabolic disturbances in the patient. The search for the cachectic factor(s) started a long time ago, and many scientific and economic efforts have been devoted to its discovery, but we are still a long way from a complete answer. The present review aims to evaluate the different molecular mechanisms and catabolic mediators (both humoural and tumoural) that are involved in cancer cachexia and to discuss their potential as targets for future clinical investigations. Is there a unique and universal mediator for muscle wasting in cancer patients? This paper briefly summarizes the main catabolic mediators (both cytokines and tumour-derived factors) involved in cancer cachexia, as well as the role of transcription factors in this syndrome and the potential anticachectic therapeutic strategies.