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Options in Oncol."],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Opinion statement<\/jats:title><jats:p>Considerable advances in the investigation and management of oesophagogastric cancer have occurred over the last few decades. While the historically dismal prognosis associated with these diseases has improved, outcomes remain very poor. Cancer cachexia is an often neglected, yet critical, factor for this patient group. There is a persuasive argument that a lack of assessment and treatment of cachexia has limited progress in oesophagogastric cancer care. In the curative setting, the stage of the host (based on factors such as body composition, function, and inflammatory status), alongside tumour stage, has the potential to influence treatment efficacy. Phenotypical features of cachexia may decrease the survival benefit of (peri-operative) chemoradiotherapy, immunotherapy, or surgical resection in patients with potentially curative malignancy. Most patients with oesophagogastric cancer unfortunately present with disease which is not amenable, or is unlikely to respond, to these treatments. In the palliative setting, host factors can similarly impair results from systemic anti-cancer therapies, cause adverse symptoms, and reduce quality of life. To optimise treatment pathways and enhance patient outcomes, we must utilise this information during clinical decision-making. As our understanding of the genesis of cancer cachexia improves and more therapeutic options, ranging from basic (e.g. exercise and nutrition) to targeted (e.g. anti-IL1 \u03b1 and anti-GDF-15), become available, there can be grounds for optimism. Cachexia can change from a hitherto neglected condition to an integral part of the oesophagogastric cancer treatment pathway.<\/jats:p>","DOI":"10.1007\/s11864-022-01028-1","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T11:04:36Z","timestamp":1666350276000},"page":"1732-1747","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Understanding Cancer Cachexia and Its Implications in Upper Gastrointestinal Cancers"],"prefix":"10.1007","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6181-7020","authenticated-orcid":false,"given":"Leo R.","family":"Brown","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry J. 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Brown declares that he has no conflict of interest. Barry J.A. Laird has received consulting fees from Actimed Therapeutics, Faraday Pharmaceuticals, Kyowa Kirin International, Grunenthal and Artelo Biosciences. He also sits on the advisory board for Actimed Therapeutics and Artelo Biosciences. Stephen J. Wigmore declares that he has no conflict of interest. Richard J.E. Skipworth has received consulting fees from Avidity Biosciences, Faraday Pharmaceuticals, Actimed Therapeutics and Helsinn Healthcare. He has also received conference funding from Helsinn Healthcare and sits on the advisory board for Actimed Therapeutics and Helsinn Healthcare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"This article does not contain any studies with human\/animal subjects performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and Animal Rights and Informed Consent"}}]}}