{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:01:39Z","timestamp":1790085699424,"version":"4.0.1"},"reference-count":161,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Cancer cachexia is conventionally viewed as muscle wasting but is increasingly recognized as a tumor-driven immunometabolic syndrome. This systemic disorder is characterized by a vicious cycle of metabolic dysregulation, systemic inflammation, and immune evasion, severely compromising the efficacy of immune checkpoint inhibitors (ICIs). Conventional single-target therapies have largely failed to disrupt this redundant pathological network. Here, we comprehensively review the therapeutic potential of Traditional Chinese Medicine (TCM) as multi-target network modulators acting at the immunometabolic interface. At the micro-level, TCM-derived monomers (such as curcumin, andrographolide, and epigallocatechin gallate (EGCG)) bidirectionally target this interface by concurrently suppressing muscle catabolism (via ubiquitin-proteasome and ferroptosis pathways) and reprogramming the immunosuppressive tumor immune microenvironment (TIME) (downregulating PD-L1 and inhibiting MDSCs\/Tregs). At the macro-level, chromatographically characterized multi-herb formulas offer systemic recalibration via the gut-muscle-immune axis, utilizing microbial metabolites to restore intestinal barrier integrity, curb systemic inflammation, and epigenetically reinvigorate exhausted CD8+ T cells. Clinically, integrating TCM with ICIs presents a promising synergistic strategy to restore patient eligibility, optimize immunotherapeutic responses, and mitigate treatment-related adverse events. This review provides a mechanistic framework for positioning TCM as a potential systemic adjuvant to break the cachexia-immunosuppression loop in modern oncology.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1934109","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:15:41Z","timestamp":1790082941000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cancer cachexia as an immunometabolic syndrome: targeting the immunometabolic interface with traditional Chinese Medicine monomers and formulas"],"prefix":"10.3389","volume":"17","author":[{"given":"Baoyi","family":"Ni","sequence":"first","affiliation":[{"name":"Mudanjiang Medical University","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhang","family":"Wang","sequence":"additional","affiliation":[{"name":"Mudanjiang City Hospital of TCM","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Xuyi County People\u2019s Hospital, Huai\u2019an","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhu","family":"Liu","sequence":"additional","affiliation":[{"name":"Hongqi Hospital Affiliated to Mudanjiang Medical University","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiming","family":"Wang","sequence":"additional","affiliation":[{"name":"Hongqi Hospital Affiliated to Mudanjiang Medical University","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"He","sequence":"additional","affiliation":[{"name":"Mudanjiang Medical University","place":["Mudanjiang, 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