{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:41:31Z","timestamp":1789047691715,"version":"build-2803163510"},"reference-count":148,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"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. Oncol."],"abstract":"<jats:p>Cancer cachexia is a multifactorial syndrome characterized by involuntary weight loss, muscle mass reduction, and systemic inflammatory response, negatively impacting the quality of life and survival of cancer patients. In gastrointestinal tumors, cachexia prevalence can reach up to 80%, presenting a complex clinical challenge. This review aims to explore the efficacy of a multimodal approach integrating nutritional support and physical activity in cancer cachexia management. Targeted dietary strategies, such as a high-protein diet enriched with omega-3 and branched-chain amino acids (BCAAs), have proven effective in counteracting muscle loss and modulating inflammatory metabolism. Physical activity, particularly resistance training, contributes to preserving lean mass and improving physical function. However, current data suggest that no single strategy is sufficient to reverse cachexia, necessitating combined treatment with supportive pharmacological therapies, including progestogens, muscle metabolism modulators, and cytokine antagonists. Despite the evidence supporting these interventions, significant gaps remain, highlighting the need for randomized clinical trials to define the optimal therapeutic protocol for gastrointestinal cancer patients with cachexia.<\/jats:p>","DOI":"10.3389\/fonc.2025.1600425","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:10:29Z","timestamp":1748563829000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Role of diet, physical activity and new drugs in the primary management of cancer cachexia in gastrointestinal tumors \u2013 a comprehensive review"],"prefix":"10.3389","volume":"15","author":[{"given":"Ester","family":"Oneda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Manno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Noventa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Libertini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Cherri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Zaniboni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2012.209","article-title":"Understanding the mechanisms and treatment options in cancer cachexia","volume":"10","author":"Fearon","year":"2013","journal-title":"Nat Rev Clin Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70218-7","article-title":"Definition and classification of cancer cachexia: an international consensus","volume":"12","author":"Fearon","year":"2011","journal-title":"Lancet Oncol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1007\/s11912-020-00916-9","article-title":"The role of malnutrition and muscle wasting in advanced lung cancer","volume":"22","author":"Jain","year":"2020","journal-title":"Curr Oncol Rep"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70153-0","article-title":"Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: A population-based study","volume":"9","author":"Prado","year":"2008","journal-title":"Lancet Oncol"},{"key":"B5","unstructured":"NCCN clinical practice guidelines in oncology: palliative care. Version 1.2025\n          \n          \n          \n          2024"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100092","article-title":"ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Cancer cachexia in adult patients: ESMO Clinical Practice Guidelines\u2606","volume":"6","author":"Arends","year":"2021","journal-title":"ESMO Open"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/cells11172671","article-title":"Transforming growth factor-beta signaling in cancer-induced cachexia: from molecular pathways to the clinics","volume":"11","author":"Balsano","year":"2022","journal-title":"Cells"},{"key":"B8","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.cmet.2012.06.011","article-title":"Cancer cachexia: mediators, signaling, and metabolic pathways","volume":"16","author":"Fearon","year":"2012","journal-title":"Cell Metabolism"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6601814","article-title":"Serum levels of IL-6 and TNF-alpha correlate with clinicopathological features and patient survival in patients with prostate cancer","volume":"90","author":"Michalaki","year":"2004","journal-title":"Br J Cancer"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2020.165798","article-title":"Functional roles of GDF15 in modulating microenvironment to promote carcinogenesis","volume":"1866","author":"Rochette","year":"2020","journal-title":"Biochim Biophys Acta - Mol Basis Dis"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2409515","article-title":"Ponsegromab for the treatment of cancer cachexia","volume":"391","author":"Groarke","year":"2024","journal-title":"N Engl J Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2019.03.012","article-title":"Mediators of cachexia in cancer patients","volume":"66","author":"Argil\u00e9s","year":"2019","journal-title":"Nutrition"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00611","article-title":"Management of cancer cachexia: ASCO guideline","volume":"38","author":"Roeland","year":"2020","journal-title":"J Clin Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2014.06.011","article-title":"A switch from white to brown fat increases energy expenditure in cancer-associated cachexia","volume":"20","author":"Petruzzelli","year":"2014","journal-title":"Cell Metab"},{"key":"B15","doi-asserted-by":"publisher","first-page":"17105","DOI":"10.1038\/nrdp.2017.105","article-title":"Cancer-associated cachexia","volume":"4","author":"Baracos","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/nu13061980","article-title":"The spectrum of malnutrition\/cachexia\/sarcopenia in oncology according to different cancer types and settings: A narrative review","volume":"13","author":"Bossi","year":"2021","journal-title":"Nutrients"},{"key":"B17","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1101\/gad.276733.115","article-title":"Mechanisms of metabolic dysfunction in cancer-associated cachexia","volume":"30","author":"Petruzzelli","year":"2016","journal-title":"Genes Dev"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.21037\/apm.2018.11.01","article-title":"Prokinetics and ghrelin for the management of cancer cachexia syndrome","volume":"8","author":"Malik","year":"2019","journal-title":"Ann palliative Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22062870","article-title":"Leptin and cancer: updated functional roles in carcinogenesis, therapeutic niches, and developments","volume":"22","author":"Lin","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.3390\/jcm8081211","article-title":"Nutrition in cancer patients","volume":"8","author":"Ravasco","year":"2019","journal-title":"J Clin Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2020.601329","article-title":"Nutritional interventions in cancer cachexia: evidence and perspectives from experimental models","volume":"7","author":"van de Worp","year":"2020","journal-title":"Front Nutr"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-021-03592-9","article-title":"Diet-related interventions for cancer-associated cachexia","volume":"147","author":"Kim","year":"2021","journal-title":"J Cancer Res Clin Oncol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3390\/nu15153391","article-title":"Relevance of dietary supplement use in gastrointestinal-cancer-associated cachexi","volume":"15","author":"Yoon","year":"2023","journal-title":"Nutrients"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19084604","article-title":"Nutritional and exercise interventions in cancer-related cachexia: an extensive narrative review","volume":"19","author":"Clemente-Su\u00e1rez","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13520","article-title":"Targeted nutritional intervention attenuates experimental lung cancer cachexia","volume":"15","author":"van de Worp","year":"2024","journal-title":"J cachexia sarcopenia Muscle"},{"key":"B26","doi-asserted-by":"publisher","first-page":"345","DOI":"10.3390\/nu14020345","article-title":"Nutritional approach to cancer cachexia: A proposal for dietitians","volume":"14","author":"Tanaka","year":"2022","journal-title":"Nutrients"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603704","article-title":"Attenuation of muscle atrophy in a murine model of cachexia by inhibition of the dsRNA-dependent protein kinase","volume":"96","author":"Eley","year":"2007","journal-title":"Br J Cancer"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/0899-9007(96)90019-2","article-title":"Cancer anorexia: new pathogenic and therapeutic insights","volume":"12","author":"Cangiano","year":"1996","journal-title":"Nutr (Burbank Los Angeles County Calif.)"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1096\/FASEBJ.2021.35.S1.02035","article-title":"\u2018Metabolism of the branched-chain amino acids are disrupted by chemotherapy drugs\u2019","volume":"35","author":"Mora","year":"2021","journal-title":"FASEB J"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1152\/physiol.2023.38.s1.5735255","article-title":"Sex differences in cachexia outcomes, anabolic signalling and BCAA metabolism following chemotherapy","author":"Mora","year":"2023","journal-title":"Physiology"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.00537.2023","article-title":"\u2018Maintenance of the Branched-Chain Amino Acid transporter LAT1 Counteracts Myotube Atrophy following Chemotherapy\u2019, American Journal of Physiology","author":"Mora","year":"2024","journal-title":"Cell Physiol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"966","DOI":"10.3390\/medicina58070966","article-title":"\u2018Nutritional interventions to improve cachexia outcomes in cancer\u2014A systematic review\u2019","volume":"58","author":"Braha","year":"2022","journal-title":"Medicina"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2015.02.004","article-title":"\u2018Changes in body composition in heart failure patients after a resistance exercise program and branched chain amino acid supplementation\u2019","volume":"35","author":"Pineda-Ju\u00e1rez","year":"2016","journal-title":"Clin Nutr"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-008-0403-7","article-title":"A randomized, double-blind, placebo-controlled trial of a beta-hydroxyl beta-methyl butyrate, glutamine, and arginine mixture for the treatment of cancer cachexia (RTOG 0122)","volume":"16","author":"Berk","year":"2008","journal-title":"Supportive Care Cancer"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1987.149","article-title":"\u2018Reduction of weight loss and tumour size in a cachexia model by a high fat diet\u2019","volume":"56","author":"Tisdale","year":"1987","journal-title":"Br J Cancer"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2018.12.001","article-title":"New insights on the regulation of cancer cachexia by N-3 polyunsaturated fatty acids","volume":"196","author":"Gorj\u00e3o","year":"2019","journal-title":"Pharmacol Ther"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1016\/J.JFF.2018.12.033","article-title":"The role of omega 3 fatty acids in suppressing muscle protein catabolism: A possible therapeutic strategy to reverse cancer cachexia","volume":"54","author":"Malta","year":"2019","journal-title":"J Funct Foods"},{"key":"B38","doi-asserted-by":"publisher","first-page":"15347354241275052","DOI":"10.1177\/15347354241275052","article-title":"Omega-3 fatty acids increase weight and quality of life scores in patients with advanced non-small cell lung cancer and cancer cachexia: A meta-analysis","volume":"23","author":"Chua","year":"2024","journal-title":"Integr Cancer Therapies"},{"key":"B39","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.clnesp.2018.02.006","article-title":"Should omega-3 fatty acids be used for adjuvant treatment of cancer cachexia","volume":"25","author":"Lavriv","year":"2018","journal-title":"Clin Nutr ESPEN"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.tibs.2015.12.001","article-title":"The warburg effect: how does it benefit cancer cells","volume":"41","author":"Liberti","year":"2016","journal-title":"Trends Biochem Sci"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1038\/s42255-020-0172-2","article-title":"We need to talk about the Warburg effect","volume":"2","author":"Deberardinis","year":"2020","journal-title":"Nat Metab"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.drudis.2017.08.003","article-title":"The Warburg effect and glucose-derived cancer theranostics","volume":"22","author":"Tekade","year":"2017","journal-title":"Drug Discov Today"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1007\/s12272-019-01185-2","article-title":"Warburg effect and its role in tumourigenesis","volume":"42","author":"Lebelo","year":"2019","journal-title":"Arch Pharmacal Res"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1096\/fj.202300649R","article-title":"The Warburg effect drives cachectic states in patients with pancreatobiliary adenocarcinoma","volume":"37","author":"Li","year":"2023","journal-title":"FASEB J"},{"key":"B45","doi-asserted-by":"publisher","first-page":"3142","DOI":"10.3390\/ijms25063142","article-title":"Targeting the warburg effect in cancer: where do we stand","volume":"25","author":"Barba","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1177\/15347354231195322","article-title":"The effect of mediterranean diet on body composition, inflammatory factors, and nutritional status in patients with cachexia induced by colorectal cancer: A randomized clinical trial","volume":"22","author":"Bagheri","year":"2023","journal-title":"Integr Cancer Therapies"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.3945\/jn.116.244129","article-title":"\u2018Postdiagnostic mediterranean and healthy nordic dietary patterns are inversely associated with all-cause mortality in long-term colorectal cancer survivors\u2019","volume":"147","author":"Ratjen","year":"2017","journal-title":"J Nutr"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.539","article-title":"\u2018Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis of observational studies\u2019","volume":"4","author":"Schwingshackl","year":"2015","journal-title":"Cancer Med"},{"key":"B49","doi-asserted-by":"publisher","first-page":"348","DOI":"10.3390\/nu14020348","article-title":"\u2018The role of diet in prognosis among cancer survivors: A systematic review and meta-analysis of dietary patterns and diet interventions\u2019","volume":"14","author":"Castro-Espin","year":"2022","journal-title":"Nutrients"},{"key":"B50","doi-asserted-by":"publisher","first-page":"4202","DOI":"10.3390\/cancers14174202","article-title":"The effects of a mediterranean diet intervention on cancer-related fatigue for patients undergoing chemotherapy: A pilot randomized controlled trial\u2019","volume":"14","author":"Kleckner","year":"2022","journal-title":"Cancers"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzaa044_014","article-title":"A ketogenic diet mitigates pancreatic cancer-associated cachexia in mice","author":"Cortez","year":"2020","journal-title":"Curr Developments Nutr"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.3390\/ijms241310753","article-title":"A ketogenic diet in combination with gemcitabine mitigates pancreatic cancer-associated cachexia in male and female KPC mice","volume":"24","author":"Cortez","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.https:\/\/doi.org\/10.3390\/nu10020206","article-title":"A ketogenic formula prevents tumor progression and cancer cachexia by attenuating systemic inflammation in colon 26 tumor-bearing mice","volume":"10","author":"Nakamura","year":"2018","journal-title":"Nutrients"},{"key":"B54","doi-asserted-by":"publisher","first-page":"2023.02.17.528937","DOI":"10.1101\/2023.02.17.528937","article-title":"Ketogenic diet promotes tumor ferroptosis but induces relative corticosterone deficiency that accelerates cachexia","author":"Ferrer","year":"2023","journal-title":"bioRxiv"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.15430\/JCP.2017.22.3.127","article-title":"Rationale, feasibility and acceptability of ketogenic diet for cancer treatment","volume":"22","author":"Chung","year":"2017","journal-title":"J Cancer Prev"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2020.1847030","article-title":"Could ketogenic diet \u201cstarve\u201d cancer? Emerging evidence","volume":"62","author":"Barrea","year":"2020","journal-title":"Crit Rev Food Sci Nutr"},{"key":"B57","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1159\/000510839","article-title":"Diet and chemotherapy: the effects of fasting and ketogenic diet on cancer treatment","volume":"65","author":"Plotti","year":"2020","journal-title":"Chemotherapy"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-021-00710-2","article-title":"The use of ketogenic diets in cancer patients: a systematic review","volume":"21","author":"R\u00f6mer","year":"2021","journal-title":"Clin Exp Med"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.3892\/ijo.2010.885","article-title":"\u03b2-Hydroxy-\u03b2-methylbutyrate (HMB) attenuates muscle and body weight loss in experimental cancer cachexia","volume":"38","author":"Aversa","year":"2011","journal-title":"Int J Oncol"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.2174\/18715206113139990321","article-title":"\u03b2-Hydroxy-\u03b2-methylbutyrate as a countermeasure for cancer cachexia: a cellular and molecular rationale","volume":"13","author":"Kim","year":"2013","journal-title":"Anti-Cancer Agents Medicinal Chem"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2022.07.041","article-title":"Advances in muscle health and nutrition: A toolkit for healthcare professionals","volume":"41","author":"Prado","year":"2022","journal-title":"Clin Nutr (Edinburgh Scotland)"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2020.03.038","article-title":"Perioperative nutrition: Recommendations from the ESPEN expert group","volume":"39","author":"Lobo","year":"2020","journal-title":"Clin Nutr"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24031849","article-title":"Targeting gut microbiota in cancer cachexia: Towards new treatment options","volume":"24","author":"Panebianco","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.003797","article-title":"Restoring specific Lactobacilli levels decreases inflammation and muscle atrophy markers in an acute leukemia mouse model","volume":"7","author":"Bindels","year":"2012","journal-title":"PloS One"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1080\/01635581.2021.2014901","article-title":"Lactobacillus rhamnosus R0011 treatment enhanced efficacy of capecitabine against colon cancer in male balb\/c mice","volume":"74","author":"Rahimpour","year":"2022","journal-title":"Nutr Cancer"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.4161\/cbt.6.9.4511","article-title":"VSL3 probiotic treatment reduces chemotherapy-induced diarrhea and weight loss","volume":"6","author":"Bowen","year":"2007","journal-title":"Cancer Biol Ther"},{"key":"B67","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1186\/s12876-019-1047-4","article-title":"A randomized double-blind placebo-controlled trial of probiotics in post-surgical colorectal cancer","volume":"19","author":"Zaharuddin","year":"2019","journal-title":"BMC Gastroenterol"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(02)00823-1","article-title":"Reversal of cancer-related wasting using oral supplementation with a combination of \u03b2-hydroxy-\u03b2-methylbutyrate, arginine, and glutamine","volume":"183","author":"May","year":"2002","journal-title":"Am J Surg"},{"key":"B69","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1038\/sj.bjc.6690654","article-title":"The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer","volume":"81","author":"Barber","year":"1999","journal-title":"Br J Cancer"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2013.01.015","article-title":"Omega-3 fatty acid-, micronutrient-, and probiotic-enriched nutrition helps body weight stabilization in head and neck cancer cachexia","author":"Yeh","year":"2013","journal-title":"surgery  medicine  Pathol  Radiol"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-004-0746-7","article-title":"Nutrition intervention improves outcomes in patients with cancer cachexia receiving chemotherapy\u2014a pilot study","volume":"13","author":"Bauer","year":"2005","journal-title":"Supportive Care Cancer"},{"key":"B72","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1016\/J.CLNU.2005.07.002","article-title":"Compliance with nutrition prescription improves outcomes in patients with unresectable pancreatic cancer","author":"Bauer","year":"2005","journal-title":"Clin Nutr"},{"key":"B73","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1475930","article-title":"The impact of nutritional intervention on quality of life and outcomes in patients with head and neck cancers undergoing chemoradiation","volume":"14","author":"Cardellini","year":"2024","journal-title":"Front Oncol"},{"key":"B74","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.appet.2015.04.049","article-title":"\u2018Nutrition therapy in cachectic cancer patients. The Tight Caloric Control (TiCaCo) pilot trial\u2019","volume":"91","author":"Waele","year":"2015","journal-title":"Appetite"},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.1007\/s13539-012-0096-0","article-title":"Cancer cachexia prevention via physical exercise: molecular mechanisms","volume":"4","author":"Gould","year":"2012","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12900","article-title":"Physical exercise at the crossroad between muscle wasting and the immune system: implications for lung cancer cachexia","volume":"13","author":"Cortiula","year":"2002","journal-title":"J Cachexia Sarcopenia Muscle."},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14020342","article-title":"Impact of cancer cachexia on cardiac and skeletal muscle: role of exercise training","volume":"14","author":"Bordignon","year":"2022","journal-title":"Cancers"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjon.2023.100335","article-title":"Exercise-based interventions for cancer cachexia: A systematic review of randomised and non-randomised controlled trials","volume":"10","author":"Cheung","year":"2023","journal-title":"Asia-Pacific J Oncol Nurs"},{"key":"B79","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2024.42.17_suppl.lba12007","article-title":"Results from a randomised, open-label trial of a multimodal intervention (exercise, nutrition and anti-inflammatory medication) plus standard care versus standard care alone to attenuate cachexia in patients with advanced cancer undergoing chemotherapy","volume":"42","author":"Solheim","year":"2024","journal-title":"J Clin Oncol"},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31120563","article-title":"Potential benefits from physical exercise in advanced cancer patients undergoing systemic therapy? A narrative review of the randomized clinical trials","volume":"31","author":"Bozzetti","year":"2024","journal-title":"Curr Oncol"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24032079","article-title":"Monomeric C-reactive protein in atherosclerotic cardiovascular disease: advances and perspectives","volume":"24","author":"Melnikov","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B82","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0000000000000091","article-title":"Role of interleukin-6 in cachexia: therapeutic implications","volume":"8","author":"Narsale","year":"2014","journal-title":"Curr Opin supportive palliative Care"},{"key":"B83","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1002\/jcsm.12201","article-title":"A randomized phase II feasibility trial of a multimodal intervention for the management of cachexia in lung and pancreatic cancer","volume":"8","author":"Solheim","year":"2017","journal-title":"Journal of Cachexia, Sarcopenia and Muscle"},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21579","article-title":"Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer","volume":"69","author":"Schmitz","year":"2019","journal-title":"CA A Cancer J Clin"},{"key":"B85","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002117","article-title":"American college of sports medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control","volume":"51","author":"Patel","year":"2019","journal-title":"Med Sci sports Exercise"},{"key":"B86","article-title":"Megestrol acetate in cancer cachexia","volume":"18","author":"Schmoll","year":"1991","journal-title":"Semin Oncol"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.1093\/JNCI\/82.13.1127","article-title":"Controlled trial of megestrol acetate for the treatment of cancer anorexia and cachexia","volume":"82","author":"Loprinzi","year":"1990","journal-title":"J Natl Cancer Institute"},{"key":"B88","doi-asserted-by":"publisher","first-page":"CD004310","DOI":"10.1002\/14651858.cd004310","article-title":"Megestrol acetate for the treatment of anorexia-cachexia syndrome","volume":"2","author":"Berenstein","year":"2005","journal-title":"Cochrane Database Systematic Rev"},{"key":"B89","doi-asserted-by":"publisher","first-page":"3756","DOI":"10.3390\/jcm11133756","article-title":"A systematic review and meta-analysis of the clinical use of megestrol acetate for cancer-related anorexia\/cachexia","volume":"11","author":"Lim","year":"2022","journal-title":"J Clin Med"},{"key":"B90","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13500","article-title":"Dose-dependent effect of megestrol acetate supplementation in cancer patients with anorexia\u2013cachexia syndrome: A meta-analysis","volume":"15","author":"Talebi","year":"2024","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"B91","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.10.3299","article-title":"Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia\/cachexia","volume":"17","author":"Loprinzi","year":"1999","journal-title":"J Clin oncol: Off J Am Soc Clin Oncol"},{"key":"B92","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/j.jpainsymman.2003.09.007","article-title":"Systematic review of megestrol acetate in the treatment of anorexia-cachexia syndrome","volume":"27","author":"Pascual L\u03ccpez","year":"2004","journal-title":"J Pain and Symptom Manage"},{"key":"B93","doi-asserted-by":"publisher","first-page":"2421","DOI":"10.1038\/s41598-021-82120-8","article-title":"A randomised, double blind, placebo-controlled trial of megestrol acetate or dexamethasone in treating symptomatic anorexia in people with advanced cancer","volume":"11","author":"Currow","year":"2021","journal-title":"Sci Rep"},{"key":"B94","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004310.pub3","article-title":"Megestrol acetate for treatment of anorexia-cachexia syndrome","volume":"3","author":"Garc\u00eda","year":"2013","journal-title":"Cochrane Database Systematic Rev"},{"key":"B95","doi-asserted-by":"publisher","first-page":"499","DOI":"10.2165\/00003495-199243040-00006","article-title":"Cancer-associated anorexia and cachexia","volume":"43","author":"Loprinzi","year":"1992","journal-title":"Drugs"},{"key":"B96","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1007\/BF00364967","article-title":"Is the pharmacological treatment of cancer cachexia possible","volume":"1","author":"Bruera","year":"1993","journal-title":"Supportive Care Cancer"},{"key":"B97","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1371\/journal.pone.0102436","article-title":"Tocilizumab, a proposed therapy for the cachexia of interleukin6-expressing lung cancer","author":"Ando","year":"2014","journal-title":"PloS One"},{"key":"B98","doi-asserted-by":"publisher","first-page":"2647-2647","DOI":"10.1200\/jco.2024.42.16_suppl.2647","article-title":"Tocilizumab for advanced non-small cell lung cancer with concomitant inflammatory cachexia: A single-centre study","volume":"42","author":"Du","year":"2024","journal-title":"J\u00a0Clin Oncol"},{"key":"B99","article-title":"Anticytokine approaches to the treatment of anorexia and cachexia","author":"Haslett","year":"1998","journal-title":"Semin Oncol"},{"key":"B100","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1136\/gut.2004.047563","article-title":"Thalidomide in the treatment of cancer cachexia: a randomised placebo controlled trial","volume":"54","author":"Gordon","year":"2005","journal-title":"Gut"},{"key":"B101","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2008.08.008","article-title":"Sophocarpine and matrine inhibit the production of TNF-alpha and IL-6 in murine macrophages and prevent cachexia-related symptoms induced by colon26 adenocarcinoma in mice","volume":"8","author":"Zhang","year":"2008","journal-title":"Int Immunopharmacol"},{"key":"B102","doi-asserted-by":"publisher","DOI":"10.3164\/jcbn.21-21","article-title":"Amelioration of cancer cachexia with preemptive administration of tumor necrosis factor-\u03b1 blocker","volume":"70","author":"Kang","year":"2021","journal-title":"J Clin Biochem Nutr"},{"key":"B103","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1002\/jcsm.12861","article-title":"Cannabinoid interventions for improving cachexia outcomes in cancer: a systematic review and meta-analysis","volume":"13","author":"Simon","year":"2021","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"B104","doi-asserted-by":"publisher","DOI":"10.7150\/jca.28246","article-title":"New prospect for cancer cachexia: medical cannabinoid","volume":"10","author":"Wang","year":"2019","journal-title":"J Cancer"},{"key":"B105","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.1847","article-title":"Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group","volume":"24","author":"Strasser","year":"2006","journal-title":"J Clin oncol: Off J Am Soc Clin Oncol"},{"key":"B106","doi-asserted-by":"publisher","first-page":"56","DOI":"10.31989\/bchd.v6i4.1007","article-title":"Liposomal hemp extract for the management of cachexia","volume":"6","author":"Blair","year":"2023","journal-title":"Bioactive Compounds Health Dis"},{"key":"B107","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12762","article-title":"Anti-cachexia therapy should target metabolism, inflammatory cytokines, and androgens in hormone-independent cancers","volume":"12","author":"Lambert","year":"2021","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"B108","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.sxmr.2018.09.006","article-title":"Selective androgen receptor modulators: current knowledge and clinical applications","volume":"7","author":"Solomon","year":"2019","journal-title":"Sexual Med Rev"},{"key":"B109","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1080\/13543784.2019.1646727","article-title":"Investigational drugs for the treatment of cancer cachexia: a focus on phase I and phase II clinical trials","volume":"28","author":"Molfino","year":"2019","journal-title":"Expert Opin Investigational Drugs"},{"key":"B110","doi-asserted-by":"publisher","DOI":"10.4088\/jcp.24f15532","article-title":"Therapeutic effects, side effects, and adverse effects of neuropsychiatric drugs in the context of treating cancer-related anorexia with olanzapine and mirtazapine","volume":"85","author":"Andrade","year":"2024","journal-title":"J Clin Psychiatry"},{"key":"B111","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.01997","article-title":"Randomized double-blind placebo-controlled study of olanzapine for chemotherapy-related anorexia in patients with locally advanced or metastatic gastric, hepatopancreaticobiliary, and lung cancer","volume":"41","author":"Sandhya","year":"2023","journal-title":"J Clin Oncol"},{"key":"B112","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.70166","article-title":"Efficacy and safety of pharmacotherapy for cancer cachexia: A systematic review and network meta-analysis","volume":"13","author":"Chen","year":"2024","journal-title":"Cancer Med"},{"key":"B113","doi-asserted-by":"publisher","DOI":"10.21037\/apm-22-1167","article-title":"Benefits and risks of off-label olanzapine use for symptom management in cancer patients-a case report","volume":"12","author":"Dev","year":"2023","journal-title":"Ann palliative Med"},{"key":"B114","doi-asserted-by":"publisher","first-page":"6725","DOI":"10.1158\/0008-5472.CAN-04-0425","article-title":"Anticachectic effects of formoterol","volume":"64","author":"Busquets","year":"2004","journal-title":"Cancer Res"},{"key":"B115","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.biochi.2018.04.009","article-title":"Effects of the beta2 agonist formoterol on atrophy signaling, autophagy, and muscle phenotype in respiratory and limb muscles of rats with cancer-induced cachexia","volume":"149","author":"Salazar-Degracia","year":"2018","journal-title":"Biochimie"},{"key":"B116","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-013-2081-3","article-title":"Phase I\/II trial of formoterol fumarate combined with megestrol acetate in cachectic patients with advanced Malignancy","volume":"22","author":"Greig","year":"2014","journal-title":"Supportive Care Cancer"},{"key":"B117","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29930","article-title":"Complete reversal of muscle wasting in experimental cancer cachexia: Additive effects of activin type II receptor inhibition and \u03b2-2 agonist","volume":"138","author":"Toledo","year":"2016","journal-title":"Int J Cancer"},{"key":"B118","doi-asserted-by":"publisher","first-page":"3547","DOI":"10.1111\/cas.15491","article-title":"Combination therapy with anamorelin and a myostatin inhibitor is advantageous for cancer cachexia in a mouse model","volume":"113","author":"Hanada","year":"2022","journal-title":"Cancer Sci"},{"key":"B119","doi-asserted-by":"publisher","DOI":"10.1158\/1538-7445.AM10-5101","article-title":"Abstract 5101: Acute inhibition of myostatin-family proteins preserves muscle in cancer cachexia","volume":"70","author":"Klimek","year":"2010","journal-title":"Cancer Res"},{"key":"B120","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2009.12.123","article-title":"Acute inhibition of myostatin-family proteins preserves skeletal muscle in mouse models of cancer cachexia","volume":"391","author":"Klimek","year":"2010","journal-title":"Biochem Biophys Res Commun"},{"key":"B121","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00121.2011","article-title":"Antibody-directed myostatin inhibition enhances muscle mass and function in tumor-bearing mice","volume":"301","author":"Murphy","year":"2011","journal-title":"Am J Physiol Regulatory Integr Comp Physiol"},{"key":"B122","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s13539-011-0049-z","article-title":"Myostatin blockage using actRIIB antagonism in mice bearing the Lewis lung carcinoma results in the improvement of muscle wasting and physical performance","volume":"3","author":"Busquets","year":"2011","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"B123","doi-asserted-by":"publisher","DOI":"10.2174\/156800909789057015","article-title":"Deacetylase inhibitors modulate the myostatin\/follistatin axis without improving cachexia in tumor-bearing mice","volume":"9","author":"Bonetto","year":"2009","journal-title":"Curr Cancer Drug Targets"},{"key":"B124","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16091696","article-title":"Updates in cancer cachexia: clinical management and pharmacologic interventions","volume":"16","author":"Pandey","year":"2024","journal-title":"Cancers"},{"key":"B125","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-016-3144-z","article-title":"Anamorelin (ONO-7643) in Japanese patients with non-small cell lung cancer and cachexia: results of a randomized phase 2 trial","volume":"24","author":"Takayama","year":"2016","journal-title":"Supportive Care Cancer"},{"key":"B126","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)71154-4","article-title":"Anamorelin for patients with cancer cachexia: an integrated analysis of two phase 2, randomised, placebo-controlled, double-blind trials","volume":"16","author":"Garcia","year":"2015","journal-title":"Lancet Oncol"},{"key":"B127","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00558-6","article-title":"Anamorelin in patients with non-small-cell lung cancer and cachexia (ROMANA 1 and ROMANA 2): results from two randomised, double-blind, phase 3 trials","volume":"17","author":"Temel","year":"2016","journal-title":"Lancet Oncol"},{"key":"B128","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1358\/dot.2022.58.3.3381585","article-title":"Anamorelin for cancer cachexia","volume":"58","author":"Nishie","year":"2022","journal-title":"Drugs Today"},{"key":"B129","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0000000000000658","article-title":"Anamorelin in Japanese patients with cancer cachexia: an update","volume":"17","author":"Wakabayashi","year":"2023","journal-title":"Curr Opin supportive palliative Care"},{"key":"B130","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1002\/jcsm.12136","article-title":"ACT-ONE - ACTION at last on cancer cachexia by adapting a novel action beta-blocker","volume":"7","author":"Lainscak","year":"2016","journal-title":"J of Cachexia, Sarcopenia and Muscle"},{"key":"B131","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12126","article-title":"Espindolol for the treatment and prevention of cachexia in patients with stage III\/IV non-small cell lung cancer or colorectal cancer: a randomized, double-blind, placebo-controlled, international multicentre phase II study (the ACT-ONE trial)","volume":"7","author":"Stewart Coats","year":"2016","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"B132","doi-asserted-by":"publisher","DOI":"10.1158\/1538-7445.am2023-368","article-title":"Abstract 368: Neutralizing antibody against GDF-15 restores cachexia","author":"He","year":"2023","journal-title":"Cancer Research"},{"key":"B133","doi-asserted-by":"publisher","DOI":"10.1158\/1538-7445.am2022-5301","article-title":"Abstract 5301: GDF-15 neutralizing antibody restores cancer-induced cachexia","author":"Wu","year":"2022","journal-title":"Cancer Research"},{"key":"B134","doi-asserted-by":"publisher","DOI":"10.1158\/1538-7445.am2024-1867","article-title":"Abstract 1867: LBL-049: A novel neutralizing antibody against GDF15 for the treatment of cachexia","author":"Wang","year":"2024","journal-title":"Cancer Research"},{"key":"B135","doi-asserted-by":"publisher","DOI":"10.1158\/1538-7445.am2023-ct054","article-title":"Abstract CT054: Phase 2 study to assess the efficacy, safety, and tolerability of the GDF-15 inhibitor ponsegromab in patients with cancer cachexia","author":"Crawford","year":"2023","journal-title":"Cancer Research"},{"key":"B136","doi-asserted-by":"publisher","DOI":"10.3390\/nu14204307","article-title":"Home artificial nutrition and energy balance in cancer patients: nutritional and clinical outcomes","volume":"14","author":"Ruggeri","year":"2022","journal-title":"Nutrients"},{"key":"B137","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2020.02.021","article-title":"Home\u00a0artificial nutrition in palliative care cancer patients: Impact on survival and performance status","volume":"39","author":"Ruggeri","year":"2020","journal-title":"Clin Nutr"},{"key":"B138","doi-asserted-by":"publisher","DOI":"10.53738\/REVMED.2023.19.855.2385","article-title":"Nutritional support for individuals with advanced oncological pathology","volume":"19","author":"Ghose","year":"2023","journal-title":"Rev M\u00e9dicale Suisse"},{"key":"B139","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2017.12.011","article-title":"\u2018Home parenteral nutrition increases\u00a0fat free mass in patients with incurable gastrointestinal cancer","volume":"38","author":"Obling","year":"2017","journal-title":"Results A randomized Controlled trial\u2019 Clin Nutr"},{"key":"B140","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2020.07.027","article-title":"Effects of enteral nutrition and parenteral nutrition on survival in patients with advanced cancer cachexia: Analysis of a multicenter prospective cohort study","volume":"40","author":"Amano","year":"2020","journal-title":"Clin Nutr"},{"key":"B141","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt549","article-title":"The prognosis of incurable cachectic cancer patients on home parenteral nutrition: a multi-centre observational study with prospective follow-up of 414 patients","volume":"25","author":"Bozzetti","year":"2014","journal-title":"Ann Oncol"},{"key":"B142","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv365","article-title":"Development\u00a0and validation of a nomogram to predict survival in incurable cachectic cancer patients on home parenteral nutrition","volume":"26","author":"Bozzetti","year":"2015","journal-title":"Ann Oncol"},{"key":"B143","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1080\/01635581.2018.1380206","article-title":"Performance status, prognostic scoring, and parenteral nutrition requirements predict survival in patients with advanced cancer receiving home parenteral nutrition","volume":"70","author":"Keane","year":"2018","journal-title":"Nutr Cancer"},{"key":"B144","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314472.204","article-title":"Home parenteral nutrition in patients with advanced cancer: a systematic review","volume":"66","author":"Fragkos","year":"2017","journal-title":"Gut"},{"key":"B145","doi-asserted-by":"publisher","DOI":"10.1177\/0115426503018002176A","article-title":"Quality of life and length of survival in advanced cancer patients on home parenteral nutrition","volume":"21","author":"Bozzetti","year":"2002","journal-title":"Clin Nutr"},{"key":"B146","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.nut.2017.03.005","article-title":"Home parenteral nutrition for advanced cancer patients: Contributes to survival","volume":"54","author":"Theilla","year":"2017","journal-title":"Nutrition"},{"key":"B147","doi-asserted-by":"publisher","DOI":"10.1080\/01635581.2020.1784441","article-title":"Home parenteral nutrition in patients with advanced cancer: a systematic review and meta-analysis","volume":"73","author":"O\u2019hanlon","year":"2020","journal-title":"Nutr Cancer"},{"key":"B148","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1016\/j.clnu.2024.03.018","article-title":"The role of the nutrition in malnourished cancer patients: Revisiting an old dilemma","volume":"43","author":"Bozzetti","year":"2024","journal-title":"Clinical Nutrition (Edinburgh, Scotland)"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1600425\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:10:31Z","timestamp":1748563831000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1600425\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":148,"alternative-id":["10.3389\/fonc.2025.1600425"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1600425","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]},"article-number":"1600425"}}