{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:06:18Z","timestamp":1790885178989,"version":"4.1.0"},"reference-count":177,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T00:00:00Z","timestamp":1714176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Despite a better understanding of the mechanisms causing cancer cachexia (CC) and development of promising pharmacologic and supportive care interventions, CC persists as an underdiagnosed and undertreated condition. CC contributes to fatigue, poor quality of life, functional impairment, increases treatment related toxicity, and reduces survival. The core elements of CC such as weight loss and poor appetite should be identified early. Currently, addressing contributing conditions (hypothyroidism, hypogonadism, and adrenal insufficiency), managing nutrition impact symptoms leading to decreased oral intake (nausea, constipation, dysgeusia, stomatitis, mucositis, pain, fatigue, depressed mood, or anxiety), and the addition of pharmacologic agents when appropriate (progesterone analog, corticosteroids, and olanzapine) is recommended. In Japan, the clinical practice has changed based on the availability of Anamorelin, a ghrelin receptor agonist that improved lean body mass, weight, and appetite-related quality of life (QoL) compared to a placebo, in phase III trials. Other promising therapeutic agents currently in trials include Espindolol, a non-selective \u03b2 blocker and a monoclonal antibody to GDF-15. In the future, a single therapeutic agent or perhaps multiple medications targeting the various mechanisms of CC may prove to be an effective strategy. Ideally, these medications should be incorporated into a multimodal interdisciplinary approach that includes exercise and nutrition.<\/jats:p>","DOI":"10.3390\/cancers16091696","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T06:13:22Z","timestamp":1714371202000},"page":"1696","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Updates in Cancer Cachexia: Clinical Management and Pharmacologic Interventions"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5926-222X","authenticated-orcid":false,"given":"Sudeep","family":"Pandey","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, Oncology and Palliative Care, Virginia Commonwealth University, Richmond, VA 23298, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Bradley","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, Oncology and Palliative Care, Virginia Commonwealth University, Richmond, VA 23298, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egidio","family":"Del Fabbro","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Palliative Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s13539-014-0142-1","article-title":"Psychosocial impact of cancer cachexia","volume":"5","author":"Hopkinson","year":"2014","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e693458","DOI":"10.1155\/2009\/693458","article-title":"Estimation of Cachexia among Cancer Patients Based on Four Definitions","volume":"2009","author":"Fox","year":"2009","journal-title":"J. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/SPC.0b013e3282f4b734","article-title":"Weight loss in patients with advanced cancer: Effects, causes, and potential management","volume":"2","author":"Jatoi","year":"2008","journal-title":"Curr. Opin. Support. Palliat. Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.clnu.2008.06.013","article-title":"Cachexia: A new definition","volume":"27","author":"Evans","year":"2008","journal-title":"Clin. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/PPO.0000000000000100","article-title":"Cancer Cachexia, Recent Advances, and Future Directions","volume":"21","author":"Penet","year":"2015","journal-title":"Cancer J. Sudbury Mass"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"489","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":"ref_7","doi-asserted-by":"crossref","first-page":"5597","DOI":"10.2147\/CMAR.S261585","article-title":"Cancer Cachexia: Definition, Staging, and Emerging Treatments","volume":"12","author":"Ni","year":"2020","journal-title":"Cancer Manag. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.ctrv.2013.11.007","article-title":"Towards a simple objective framework for the investigation and treatment of cancer cachexia: The Glasgow Prognostic Score","volume":"40","author":"Douglas","year":"2014","journal-title":"Cancer Treat. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1200\/JCO.2014.56.1894","article-title":"Diagnostic Criteria for the Classification of Cancer-Associated Weight Loss","volume":"33","author":"Martin","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1002\/jcsm.12275","article-title":"Development and validation of a clinically applicable score to classify cachexia stages in advanced cancer patients","volume":"9","author":"Zhou","year":"2018","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"111880","DOI":"10.1016\/j.nut.2022.111880","article-title":"Cachexia staging score predicts survival in patients with cancer who receive palliative care","volume":"106","author":"Ueshima","year":"2023","journal-title":"Nutrition"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.gtc.2009.12.014","article-title":"The epidemiology of obesity","volume":"39","author":"Nguyen","year":"2010","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4103\/jehp.jehp_4_15","article-title":"Evaluation of body image in cancer patients and its association with clinical variables","volume":"6","author":"Bahrami","year":"2017","journal-title":"J. Educ. Health Promot."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Brederecke, J., Heise, A., and Zimmermann, T. (2021). Body image in patients with different types of cancer. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0260602"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1046\/j.1365-2354.1998.00108.x","article-title":"Research with families in palliative care: Conceptual and methodological challenges","volume":"7","author":"CClement","year":"1998","journal-title":"Eur. J. Cancer Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/S0149-2918(05)80001-3","article-title":"Prognostic effect of weight loss prior tochemotherapy in cancer patients","volume":"69","author":"Dewys","year":"1980","journal-title":"Am. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.1038\/sj.bjc.6601781","article-title":"Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers?","volume":"90","author":"Ross","year":"2004","journal-title":"Br. J. Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1007\/s00520-013-1762-2","article-title":"Weight changes correlate with alterations in subjective physical function in advanced cancer patients referred to a specialized nutrition and rehabilitation team","volume":"21","author":"Parmar","year":"2013","journal-title":"Support. Care Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/S0959-8049(97)10090-9","article-title":"Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies?","volume":"34","author":"Andreyev","year":"1998","journal-title":"Eur. J. Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1200\/JCO.1993.11.10.2043","article-title":"Effect of dietary counseling on food intake, body weight, response rate, survival, and quality of life in cancer patients undergoing chemotherapy: A prospective, randomized study","volume":"11","author":"Ovesen","year":"1993","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1080\/01635589809514722","article-title":"Impact of weight loss, appetite, and the inflammatory response on quality of life in gastrointestinal cancer patients","volume":"32","author":"McMillan","year":"1998","journal-title":"Nutr. Cancer"},{"key":"ref_23","first-page":"301","article-title":"Weight loss in cancer patients: A plea for a better awareness of the issue","volume":"20","author":"Mariani","year":"2012","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1200\/JCO.2012.45.2722","article-title":"Cancer cachexia in the age of obesity: Skeletal muscle depletion is a powerful prognostic factor, independent of body mass index","volume":"31","author":"Martin","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s13539-014-0128-z","article-title":"Patients\u2019 rationale for declining participation in a cancer-associated weight loss study","volume":"5","author":"Wanger","year":"2014","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1186\/1745-6215-15-399","article-title":"Interventions to improve recruitment and retention in clinical trials: A survey and workshop to assess current practice and future priorities","volume":"15","author":"Bower","year":"2014","journal-title":"Trials"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Caldwell, P.H.Y., Hamilton, S., Tan, A., and Craig, J.C. (2010). Strategies for Increasing Recruitment to Randomised Controlled Trials: Systematic Review. PLoS Med., 7.","DOI":"10.1371\/journal.pmed.1000368"},{"key":"ref_28","first-page":"444","article-title":"Symptom evaluation in palliative medicine: Patient report vs systematic assessment","volume":"14","author":"Homsi","year":"2006","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"181","DOI":"10.12788\/jcso.0133","article-title":"Health professionals\u2019 attitudes toward the detection and management of cancer-related anorexia-cachexia syndrome, and a proposal for standardized assessment","volume":"13","author":"Jatoi","year":"2015","journal-title":"J. Community Support. Oncol."},{"key":"ref_30","unstructured":"(2024, February 12). Understanding the Mechanisms and Treatment Options in Cancer Cachexia|Nature Reviews Clinical Oncology. Available online: https:\/\/www.nature.com\/articles\/nrclinonc.2012.209."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"5767","DOI":"10.1002\/cncr.25681","article-title":"Symptom burden and performance status in a population-based cohort of ambulatory cancer patients","volume":"116","author":"Barbera","year":"2010","journal-title":"Cancer"},{"key":"ref_32","unstructured":"(2024, February 12). ESPEN Guidelines on Nutrition in Cancer Patients\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/27637832\/."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/j.jand.2013.09.027","article-title":"The abridged patient-generated subjective global assessment is a useful tool for early detection and characterization of cancer cachexia","volume":"114","author":"Vigano","year":"2014","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1080\/0284186X.2016.1219047","article-title":"Physical performance measures for predicting outcome in cancer patients: A systematic review","volume":"55","author":"Verweij","year":"2016","journal-title":"Acta Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5547","DOI":"10.1016\/j.clnu.2021.09.034","article-title":"Nutritional status and physical performance using handgrip and SPPB tests in hospitalized older adults","volume":"40","author":"Amasene","year":"2021","journal-title":"Clin. Nutr. Edinb. Scotl."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.clnu.2010.09.010","article-title":"Hand grip strength: Outcome predictor and marker of nutritional status","volume":"30","author":"Norman","year":"2011","journal-title":"Clin. Nutr. Edinb. Scotl."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.2147\/CIA.S194543","article-title":"Grip Strength: An Indispensable Biomarker For Older Adults","volume":"14","author":"Bohannon","year":"2019","journal-title":"Clin. Interv. Aging"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00223-019-00545-w","article-title":"Assessment of Muscle Function and Physical Performance in Daily Clinical Practice: A position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)","volume":"105","author":"Beaudart","year":"2019","journal-title":"Calcif. Tissue Int."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1182\/blood.2019000758","article-title":"Gait speed, grip strength, and clinical outcomes in older patients with hematologic malignancies","volume":"134","author":"Liu","year":"2019","journal-title":"Blood"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Pavasini, R., Guralnik, J., Brown, J.C., di Bari, M., Cesari, M., Landi, F., Vaes, B., Legrand, D., Verghese, J., and Wang, C. (2016). Short Physical Performance Battery and all-cause mortality: Systematic review and meta-analysis. BMC Med., 14.","DOI":"10.1186\/s12916-016-0763-7"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4287","DOI":"10.1182\/blood-2012-12-471680","article-title":"Geriatric assessment predicts survival for older adults receiving induction chemotherapy for acute myelogenous leukemia","volume":"121","author":"Klepin","year":"2013","journal-title":"Blood"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1479973120961846","DOI":"10.1177\/1479973120961846","article-title":"Short-Physical Performance Battery (SPPB) score is associated with postoperative pulmonary complications in elderly patients undergoing lung resection surgery: A prospective multicenter cohort study","volume":"17","author":"Hanada","year":"2020","journal-title":"Chron. Respir. Dis."},{"key":"ref_43","first-page":"e229","article-title":"Current and future care of patients with the cancer anorexia-cachexia syndrome","volume":"35","year":"2015","journal-title":"Am. Soc. Clin. Oncol. Educ. Book Am. Soc. Clin. Oncol. Annu. Meet."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1097\/SPC.0000000000000300","article-title":"Practical approaches to managing cancer patients with weight loss","volume":"11","author":"Orr","year":"2017","journal-title":"Curr. Opin. Support. Palliat. Care"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1634\/theoncologist.2012-0169","article-title":"The relationship between body composition and response to neoadjuvant chemotherapy in women with operable breast cancer","volume":"17","author":"Parsons","year":"2012","journal-title":"Oncologist"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"629","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":"ref_47","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.jpainsymman.2011.09.010","article-title":"Relationships among body mass index, longitudinal body composition alterations, and survival in patients with locally advanced pancreatic cancer receiving chemoradiation: A pilot study","volume":"44","author":"Dalal","year":"2012","journal-title":"J. Pain Symptom Manag."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2416","DOI":"10.1245\/s10434-014-4285-2","article-title":"Characterization of Anthropometric Changes that Occur During Neoadjuvant Therapy for Potentially Resectable Pancreatic Cancer","volume":"22","author":"Cooper","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1139\/h2012-079","article-title":"A critical evaluation of body composition modalities used to assess adipose and skeletal muscle tissue in cancer","volume":"37","author":"Mourtzakis","year":"2012","journal-title":"Appl. Physiol. Nutr. Metab. Physiol. Appl. Nutr. Metab."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/s41574-023-00943-z","article-title":"Sarcopenic obesity in older adults: A clinical overview","volume":"20","author":"Prado","year":"2024","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Wang, J.-C., Wu, W.-T., Chang, K.-V., Chen, L.-R., Chi, S.-Y., Kara, M., and \u00d6z\u00e7akar, L. (2021). Ultrasound Imaging for the Diagnosis and Evaluation of Sarcopenia: An Umbrella Review. Life, 12.","DOI":"10.3390\/life12010009"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1002\/jcsm.13149","article-title":"Diagnostic test accuracy of ultrasound for sarcopenia diagnosis: A systematic review and meta-analysis","volume":"14","author":"Fu","year":"2023","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_53","unstructured":"(2024, February 12). Estimating Survival in Patients with Cancer Receiving Palliative Care: Is Analysis of Body Composition Using Bioimpedance Helpful?\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/19663711\/."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"601434","DOI":"10.1155\/2011\/601434","article-title":"Cancer Cachexia: Mechanisms and Clinical Implications","volume":"2011","author":"Donohoe","year":"2011","journal-title":"Gastroenterol. Res. Pract."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"ii27","DOI":"10.1093\/annonc\/mdy093","article-title":"Struggling with nutrition in patients with advanced cancer: Nutrition and nourishment-focusing on metabolism and supportive care","volume":"29","author":"Arends","year":"2018","journal-title":"Ann. Oncol. Off. J. Eur. Soc. Med. Oncol."},{"key":"ref_56","first-page":"119","article-title":"The value of physical performance measurements alongside assessment of sarcopenia in predicting receipt and completion of planned treatment in non-small cell lung cancer: An observational exploratory study","volume":"26","author":"Collins","year":"2018","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1177\/1559827617725283","article-title":"Understanding the Role of Exercise in Cancer Cachexia Therapy","volume":"13","author":"Hardee","year":"2017","journal-title":"Am. J. Lifestyle Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e290","DOI":"10.3747\/co.24.3619","article-title":"Exercise for people with cancer: A systematic review","volume":"24","author":"Segal","year":"2017","journal-title":"Curr. Oncol."},{"key":"ref_59","first-page":"2371","article-title":"Combined exercise and nutritional rehabilitation in outpatients with incurable cancer: A systematic review","volume":"27","author":"Hall","year":"2019","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1634\/theoncologist.2011-0133","article-title":"Physical exercise for cancer patients with advanced disease: A randomized controlled trial","volume":"16","author":"Oldervoll","year":"2011","journal-title":"Oncologist"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Malcolm, L., Mein, G., Jones, A., Talbot-Rice, H., Maddocks, M., and Bristowe, K. (2016). Strength in numbers: Patient experiences of group exercise within hospice palliative care. BMC Palliat. Care, 15.","DOI":"10.1186\/s12904-016-0173-9"},{"key":"ref_62","doi-asserted-by":"crossref","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":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"59","DOI":"10.21037\/apm.2018.08.05","article-title":"Combination therapy in cachexia","volume":"8","year":"2019","journal-title":"Ann. Palliat. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"103371","DOI":"10.1016\/j.critrevonc.2021.103371","article-title":"Muscle hypertrophy in cancer patients and survivors via strength training.A meta-analysis and meta-regression","volume":"163","author":"Koeppel","year":"2021","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_65","first-page":"667","article-title":"Nutritional support for head and neck cancer patients receiving radiotherapy: A systematic review","volume":"18","author":"Garg","year":"2010","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.clnu.2013.06.012","article-title":"Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: A systematic review","volume":"32","author":"Langius","year":"2013","journal-title":"Clin. Nutr. Edinb. Scotl."},{"key":"ref_67","first-page":"469","article-title":"Nutrition intervention approaches to reduce malnutrition in oncology patients: A systematic review","volume":"24","author":"Lee","year":"2016","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1093\/annonc\/mdy114","article-title":"Systematic review and meta-analysis of the evidence for oral nutritional intervention on nutritional and clinical outcomes during chemo(radio)therapy: Current evidence and guidance for design of future trials","volume":"29","author":"Laviano","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e843","DOI":"10.1634\/theoncologist.2019-0856","article-title":"Impact on Health-Related Quality of Life of Parenteral Nutrition for Patients with Advanced Cancer Cachexia: Results from a Randomized Controlled Trial","volume":"25","author":"Bouleuc","year":"2020","journal-title":"Oncologist"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1089\/jpm.2011.0098","article-title":"Clinical outcomes and contributors to weight loss in a cancer cachexia clinic","volume":"14","author":"Hui","year":"2011","journal-title":"J. Palliat. Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/0002-9610(83)90067-3","article-title":"Tumor-associated gastroparesis: Correction with metoclopramide","volume":"145","author":"Shivshanker","year":"1983","journal-title":"Am. J. Surg."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s10620-008-0354-3","article-title":"Diagnostic and therapeutic approach to pancreatic cancer-associated gastroparesis: Literature review and our experience","volume":"54","author":"Leung","year":"2009","journal-title":"Dig. Dis. Sci."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2898","DOI":"10.1016\/j.clnu.2021.02.005","article-title":"ESPEN practical guideline: Clinical Nutrition in cancer","volume":"40","author":"Muscaritoli","year":"2021","journal-title":"Clin. Nutr. Edinb. Scotl."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1001\/jamaoncol.2020.1052","article-title":"Olanzapine for the Treatment of Advanced Cancer-Related Chronic Nausea and\/or Vomiting: A Randomized Pilot Trial","volume":"6","author":"Navari","year":"2020","journal-title":"JAMA Oncol."},{"key":"ref_75","unstructured":"(2024, February 12). Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting|NEJM. Available online: https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1515725."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.jpainsymman.2010.03.026","article-title":"Consensus recommendations for the management of constipation in patients with advanced, progressive illness","volume":"40","author":"Librach","year":"2010","journal-title":"J. Pain Symptom Manag."},{"key":"ref_77","first-page":"1607","article-title":"Relationship between malnutrition and the presence of symptoms of anxiety and depression in hospitalized cancer patients","volume":"30","author":"Barrios","year":"2022","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1111\/j.1365-2354.2006.00760.x","article-title":"Cancer chemotherapy and cachexia: Mirtazapine and olanzapine are 5-HT3 antagonists with good antinausea effects","volume":"16","author":"Kast","year":"2007","journal-title":"Eur. J. Cancer Care"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1177\/1049909109345685","article-title":"Phase II trial of mirtazapine for cancer-related cachexia and anorexia","volume":"27","author":"Riechelmann","year":"2010","journal-title":"Am. J. Hosp. Palliat. Care"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1176\/appi.psy.47.5.440","article-title":"Mirtazapine for severe gastroparesis unresponsive to conventional prokinetic treatment","volume":"47","author":"Kim","year":"2006","journal-title":"Psychosomatics"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1016\/j.jpainsymman.2021.05.017","article-title":"Mirtazapine in Cancer-Associated Anorexia and Cachexia: A Double-Blind Placebo-Controlled Randomized Trial","volume":"62","author":"Hunter","year":"2021","journal-title":"J. Pain Symptom Manag."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1634\/theoncologist.2011-0151","article-title":"Preliminary report: Vitamin D deficiency in advanced cancer patients with symptoms of fatigue or anorexia","volume":"16","author":"Dev","year":"2011","journal-title":"Oncologist"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"831934","DOI":"10.3389\/fnut.2022.831934","article-title":"Managing Nutrition Impact Symptoms in Cancer Cachexia: A Case Series and Mini Review","volume":"9","author":"Khorasanchi","year":"2022","journal-title":"Front. Nutr."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"915","DOI":"10.6004\/jnccn.2016.0094","article-title":"Cannabinoids for Symptom Management and Cancer Therapy: The Evidence","volume":"14","author":"Davis","year":"2016","journal-title":"J. Natl. Compr. Cancer Netw. JNCCN"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.1093\/annonc\/mdq727","article-title":"Delta-9-tetrahydrocannabinol may palliate altered chemosensory perception in cancer patients: Results of a randomized, double-blind, placebo-controlled pilot trial","volume":"22","author":"Brisbois","year":"2011","journal-title":"Ann. Oncol. Off. J. Eur. Soc. Med. Oncol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1002\/(SICI)1097-0142(19980515)82:10<1938::AID-CNCR18>3.0.CO;2-U","article-title":"A randomized, controlled clinical trial to evaluate the effects of zinc sulfate on cancer patients with taste alterations caused by head and neck irradiation","volume":"82","author":"Ripamonti","year":"1998","journal-title":"Cancer"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1016\/j.ijrobp.2006.10.046","article-title":"Does zinc sulfate prevent therapy-induced taste alterations in head and neck cancer patients? Results of phase III double-blind, placebo-controlled trial from the North Central Cancer Treatment Group (N01C4)","volume":"67","author":"Halyard","year":"2007","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.mce.2010.04.005","article-title":"The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights","volume":"335","author":"Coutinho","year":"2011","journal-title":"Mol Cell Endocrinol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"3076","DOI":"10.1200\/JCO.2012.44.4661","article-title":"Reduction of cancer-related fatigue with dexamethasone: A double-blind, randomized, placebo-controlled trial in patients with advanced cancer","volume":"31","author":"Yennurajalingam","year":"2013","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_90","first-page":"751","article-title":"Action of oral methylprednisolone in terminal cancer patients: A prospective randomized double-blind study","volume":"69","author":"Bruera","year":"1985","journal-title":"Cancer Treat. Rep."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1002\/1097-0142(197406)33:6<1607::AID-CNCR2820330620>3.0.CO;2-V","article-title":"Corticosteroid therapy of preterminal gastrointestinal cancer","volume":"33","author":"Moertel","year":"1974","journal-title":"Cancer"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"3221","DOI":"10.1200\/JCO.2013.54.3926","article-title":"Efficacy of Methylprednisolone on Pain, Fatigue, and Appetite Loss in Patients with Advanced Cancer Using Opioids: A Randomized, Placebo-Controlled, Double-Blind Trial","volume":"32","author":"Paulsen","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_93","first-page":"1041","article-title":"The use and toxicity of steroids in the management of patients with brain metastases","volume":"16","author":"Sturdza","year":"2008","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_94","first-page":"166","article-title":"Megestrol acetate: A systematic review usefulness about the weight gain in neoplastic patients with cachexia","volume":"119","author":"Juan","year":"2002","journal-title":"Med. Clin."},{"key":"ref_95","doi-asserted-by":"crossref","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":"Berenstein","year":"2004","journal-title":"J. Pain Symptom Manag."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"636","DOI":"10.20452\/pamw.510","article-title":"Effects of megestrol acetate in patients with cancer anorexia-cachexia syndrome--a systematic review and meta-analysis","volume":"118","author":"Jaeschke","year":"2008","journal-title":"Pol. Arch. Med. Wewn."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.1210\/jcem.87.5.8505","article-title":"Effects of testosterone replacement and\/or resistance exercise on the composition of megestrol acetate stimulated weight gain in elderly men: A randomized controlled trial","volume":"87","author":"Lambert","year":"2002","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1002\/1097-0142(19900915)66:6<1279::AID-CNCR2820660630>3.0.CO;2-R","article-title":"A controlled trial of megestrol acetate on appetite, caloric intake, nutritional status, and other symptoms in patients with advanced cancer","volume":"66","author":"Bruera","year":"1990","journal-title":"Cancer"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1200\/JCO.1996.14.4.1077","article-title":"Effects of medroxyprogesterone acetate on appetite, weight, and quality of life in advanced-stage non-hormone-sensitive cancer: A placebo-controlled multicenter study","volume":"14","author":"Simons","year":"1996","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_100","first-page":"7048610","article-title":"Megestrol Acetate-Induced Symptomatic Hypogonadism in a Male Patient","volume":"2018","author":"Munshi","year":"2018","journal-title":"Case Rep. Endocrinol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1210\/jc.2006-2734","article-title":"Megestrol Acetate Use for Weight Gain Should Be Carefully Considered","volume":"92","author":"Evans","year":"2007","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1001\/jama.1981.03310450039020","article-title":"delta 9-tetrahydrocannabinol in clinical oncology","volume":"245","author":"Poster","year":"1981","journal-title":"JAMA"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/0885-3924(94)00117-4","article-title":"Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS","volume":"10","author":"Beal","year":"1995","journal-title":"J. Pain Symptom Manag."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"3394","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":"ref_105","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/0091-3057(91)90385-F","article-title":"Recent clinical experience with dronabinol","volume":"40","author":"Plasse","year":"1991","journal-title":"Pharmacol. Biochem. Behav."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1200\/JCO.2002.20.2.567","article-title":"Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: A North Central Cancer Treatment Group study","volume":"20","author":"Jatoi","year":"2002","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_107","first-page":"3029","article-title":"The effect of nabilone on appetite, nutritional status, and quality of life in lung cancer patients: A randomized, double-blind clinical trial","volume":"26","author":"Turcott","year":"2018","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.schres.2008.09.025","article-title":"Weight effects associated with antipsychotics: A comprehensive database analysis","volume":"110","author":"Parsons","year":"2009","journal-title":"Schizophr. Res."},{"key":"ref_109","first-page":"8097","article-title":"MASCC antiemetics in advanced cancer updated guideline","volume":"29","author":"Davis","year":"2021","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/s00520-004-0755-6","article-title":"A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: A Hoosier Oncology Group study","volume":"13","author":"Navari","year":"2005","journal-title":"Support. Care Cancer"},{"key":"ref_111","first-page":"1285","article-title":"A phase II trial of olanzapine, dexamethasone, and palonosetron for the prevention of chemotherapy-induced nausea and vomiting: A Hoosier oncology group study","volume":"15","author":"Navari","year":"2007","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/S0885-3924(02)00391-3","article-title":"A pilot exploration of the antiemetic activity of olanzapine for the relief of nausea in patients with advanced cancer and pain","volume":"23","author":"Passik","year":"2002","journal-title":"J. Pain Symptom Manag."},{"key":"ref_113","first-page":"2649","article-title":"Olanzapine for cachexia in patients with advanced cancer: An exploratory study of effects on weight and metabolic cytokines","volume":"23","author":"Naing","year":"2015","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_114","first-page":"951","article-title":"Treatment of cancer-related anorexia with olanzapine and megestrol acetate: A randomized trial","volume":"18","author":"Navari","year":"2010","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"2617","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. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3109\/0284186X.2012.724536","article-title":"Non-steroidal anti-inflammatory treatment in cancer cachexia: A systematic literature review","volume":"52","author":"Solheim","year":"2013","journal-title":"Acta Oncol. Stockh. Swed."},{"key":"ref_117","first-page":"CD008664","article-title":"Thalidomide for managing cancer cachexia","volume":"2012","author":"Reid","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1111\/j.1365-2354.2011.01255.x","article-title":"Poor tolerability of thalidomide in end-stage oesophageal cancer","volume":"20","author":"Wilkes","year":"2011","journal-title":"Eur. J. Cancer Care"},{"key":"ref_119","doi-asserted-by":"crossref","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":"ref_120","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1046\/j.1365-2036.2003.01457.x","article-title":"Oesophageal cancer and cachexia: The effect of short-term treatment with thalidomide on weight loss and lean body mass","volume":"17","author":"Khan","year":"2003","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jpainsymman.2011.03.007","article-title":"A Phase II dose titration study of thalidomide for cancer-associated anorexia","volume":"43","author":"Davis","year":"2011","journal-title":"J. Pain Symptom Manag."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1089\/jpm.2012.0146","article-title":"The role of thalidomide and placebo for the treatment of cancer-related anorexia-cachexia symptoms: Results of a double-blind placebo-controlled randomized study","volume":"15","author":"Yennurajalingam","year":"2012","journal-title":"J. Palliat. Med."},{"key":"ref_123","unstructured":"(2024, February 12). Anticachectic and Antitumor Effect of Eicosapentaenoic Acid and Its Effect on Protein Turnover|Semantic Scholar. Available online: https:\/\/www.semanticscholar.org\/paper\/Anticachectic-and-antitumor-effect-of-acid-and-its-Beck-Smith\/c37c2ec76348086be6ee49be857052234d15a0d0."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1136\/gut.52.10.1479","article-title":"Effect of a protein and energy dense n-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: A randomised double blind trial","volume":"52","author":"Fearon","year":"2003","journal-title":"Gut"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"3401","DOI":"10.1200\/JCO.2005.04.5724","article-title":"Double-blind, placebo-controlled, randomized study of eicosapentaenoic acid diester in patients with cancer cachexia","volume":"24","author":"Fearon","year":"2006","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1002\/cncr.25709","article-title":"Nutritional intervention with fish oil provides a benefit over standard of care for weight and skeletal muscle mass in patients with nonsmall cell lung cancer receiving chemotherapy","volume":"117","author":"Murphy","year":"2011","journal-title":"Cancer"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.3945\/jn.110.121202","article-title":"Oral nutritional supplements containing (n-3) polyunsaturated fatty acids affect the nutritional status of patients with stage III non-small cell lung cancer during multimodality treatment","volume":"140","author":"Langius","year":"2010","journal-title":"J. Nutr."},{"key":"ref_128","first-page":"CD004597","article-title":"Eicosapentaenoic acid (EPA, an omega-3 fatty acid from fish oils) for the treatment of cancer cachexia","volume":"2017","author":"Dewey","year":"2007","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1177\/0269216311418709","article-title":"A systematic review on the role of fish oil for the treatment of cachexia in advanced cancer: An EPCRC cachexia guidelines project","volume":"26","author":"Ries","year":"2012","journal-title":"Palliat. Med."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1016\/j.jpainsymman.2008.06.005","article-title":"Anorexia-cachexia syndrome: A systematic review of the role of dietary polyunsaturated Fatty acids in the management of symptoms, survival, and quality of life","volume":"37","author":"Mazzotta","year":"2009","journal-title":"J. Pain Symptom Manag."},{"key":"ref_131","first-page":"797513","article-title":"Omega-3 Fatty Acid Supplementation and Its Impact on Systemic Inflammation and Body Weight in Patients with Cancer Cachexia-A Systematic Review and Meta-Analysis","volume":"8","author":"Andrade","year":"2021","journal-title":"Front. Nutr."},{"key":"ref_132","first-page":"CD004310","article-title":"Megestrol acetate for treatment of anorexia-cachexia syndrome","volume":"2013","author":"Garcia","year":"2013","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1097\/01.qai.0000197546.56131.40","article-title":"Oxandrolone in the treatment of HIV-associated weight loss in men: A randomized, double-blind, placebo-controlled study","volume":"41","author":"Grunfeld","year":"2006","journal-title":"J. Acquir. Immune Defic. Syndr. 1999"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"3299","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":"ref_135","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1002\/1097-0142(19860701)58:1<183::AID-CNCR2820580131>3.0.CO;2-3","article-title":"Influence of nandrolone decanoate on weight loss in advanced non-small cell lung cancer","volume":"58","author":"Chlebowski","year":"1986","journal-title":"Cancer"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/S1470-2045(13)70055-X","article-title":"Effects of enobosarm on muscle wasting and physical function in patients with cancer: A double-blind, randomised controlled phase 2 trial","volume":"14","author":"Dobs","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s11912-016-0522-0","article-title":"Study Design and Rationale for the Phase 3 Clinical Development Program of Enobosarm, a Selective Androgen Receptor Modulator, for the Prevention and Treatment of Muscle Wasting in Cancer Patients (POWER Trials)","volume":"18","author":"Crawford","year":"2016","journal-title":"Curr. Oncol. Rep."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"9618","DOI":"10.1200\/jco.2014.32.15_suppl.9618","article-title":"Enobosarm and lean body mass in patients with non-small cell lung cancer","volume":"32","author":"Crawford","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_139","first-page":"2599","article-title":"Testosterone replacement for fatigue in hypogonadal ambulatory males with advanced cancer: A preliminary double-blind placebo-controlled trial","volume":"21","author":"Garcia","year":"2013","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_140","unstructured":"Garcia, J.M. (2023, December 31). Improving Cancer-related Fatigue, Sexual Dysfunction and Quality of Life in Older Men with Cancer and Androgen Deficiency. clinicaltrials.gov, Clinical Trial Registration NCT04301765, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04301765."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1056\/NEJMoa010342","article-title":"Reversal of catabolism by beta-blockade after severe burns","volume":"345","author":"Herndon","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/S0959-8049(99)00273-7","article-title":"Beta-adrenoceptor activity and resting energy metabolism in weight losing cancer patients","volume":"36","author":"Hyltander","year":"2000","journal-title":"Eur. J. Cancer"},{"key":"ref_143","first-page":"80","article-title":"\u03b2-adrenergic agonists: Substances with anabolic effect in animals for meat production","volume":"14","year":"2012","journal-title":"MESO"},{"key":"ref_144","unstructured":"(2023, February 13). 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)\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/27386169\/."},{"key":"ref_145","unstructured":"(2023, February 13). Ghrelin Is a Growth-Hormone-Releasing Acylated Peptide from Stomach|Nature. Available online: https:\/\/www.nature.com\/articles\/45230."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/S0006-291X(02)03028-0","article-title":"Anti-cachectic effect of ghrelin in nude mice bearing human melanoma cells","volume":"301","author":"Hanada","year":"2003","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_147","first-page":"1393","article-title":"Effects of ghrelin on anorexia in tumor-bearing mice with eicosanoid-related cachexia","volume":"28","author":"Wang","year":"2006","journal-title":"Int. J. Oncol."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"3004","DOI":"10.1210\/en.2007-0016","article-title":"Ghrelin Treatment Causes Increased Food Intake and Retention of Lean Body Mass in a Rat Model of Cancer Cachexia","volume":"148","author":"DeBoer","year":"2007","journal-title":"Endocrinology"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1053\/gast.2002.35954","article-title":"The role of the gastric afferent vagal nerve in ghrelin-induced feeding and growth hormone secretion in rats","volume":"123","author":"Date","year":"2002","journal-title":"Gastroenterology"},{"key":"ref_150","unstructured":"(2023, February 13). Ghrelin Inhibits Leptin- and Activation-Induced Proinflammatory Cytokine Expression by Human Monocytes and T Cells\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/15232612\/."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"5992","DOI":"10.1210\/jcem.86.12.8111","article-title":"Ghrelin enhances appetite and increases food intake in humans","volume":"86","author":"Wren","year":"2001","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"2832","DOI":"10.1210\/jc.2003-031768","article-title":"Ghrelin increases energy intake in cancer patients with impaired appetite: Acute, randomized, placebo-controlled trial","volume":"89","author":"Neary","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"4785","DOI":"10.1002\/cncr.27430","article-title":"Effects of ghrelin administration during chemotherapy with advanced esophageal cancer patients","volume":"118","author":"Hiura","year":"2012","journal-title":"Cancer"},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1038\/35086018","article-title":"Ghrelin: An orexigenic and somatotrophic signal from the stomach","volume":"2","author":"Inui","year":"2001","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"108","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":"ref_156","doi-asserted-by":"crossref","first-page":"519","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":"ref_157","doi-asserted-by":"crossref","first-page":"415","DOI":"10.2174\/138920207783591672","article-title":"Myostatin in the pathophysiology of skeletal muscle","volume":"8","author":"Carnac","year":"2007","journal-title":"Curr. Genomics"},{"key":"ref_158","doi-asserted-by":"crossref","unstructured":"Chen, M.-M., Zhao, Y.-P., Zhao, Y., Deng, S.-L., and Yu, K. (2021). Regulation of Myostatin on the Growth and Development of Skeletal Muscle. Front. Cell Dev. Biol., 9.","DOI":"10.3389\/fcell.2021.785712"},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1097\/SPC.0b013e32834bddf9","article-title":"Targeting the myostatin signaling pathway to treat muscle wasting diseases","volume":"5","author":"Han","year":"2011","journal-title":"Curr. Opin. Support. Palliat. Care"},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1097\/MPA.0b013e318279b87f","article-title":"Disrupting cytokine signaling in pancreatic cancer: A phase I\/II study of Etanercept in combination with Gemcitabine in patients with advanced disease","volume":"42","author":"Wu","year":"2013","journal-title":"Pancreas"},{"key":"ref_161","first-page":"18","article-title":"A multicenter, phase II study of infliximab plus gemcitabine in pancreatic cancer cachexia","volume":"6","author":"Wiedenmann","year":"2008","journal-title":"J. Support. Oncol."},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/S1470-2045(14)70155-X","article-title":"MABp1, a first-in-class true human antibody targeting interleukin-1\u03b1 in refractory cancers: An open-label, phase 1 dose-escalation and expansion study","volume":"15","author":"Hong","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1038\/nm1677","article-title":"Tumor-induced anorexia and weight loss are mediated by the TGF-beta superfamily cytokine MIC-1","volume":"13","author":"Johnen","year":"2007","journal-title":"Nat. Med."},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1002\/jcsm.12033","article-title":"Plasma growth differentiation factor 15 is associated with weight loss and mortality in cancer patients","volume":"6","author":"Lerner","year":"2015","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.ygyno.2010.05.032","article-title":"Growth differentiation factor-15 as a prognostic biomarker in ovarian cancer","volume":"118","author":"Staff","year":"2010","journal-title":"Gynecol. Oncol."},{"key":"ref_166","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1111\/jcmm.12830","article-title":"Growth differentiation factor 15 is a promising diagnostic and prognostic biomarker in colorectal cancer","volume":"20","author":"Li","year":"2016","journal-title":"J. Cell. Mol. Med."},{"key":"ref_167","unstructured":"(2023, February 13). Non-Homeostatic Body Weight Regulation through a Brainstem-Restricted Receptor for GDF15|Nature. Available online: https:\/\/www.nature.com\/articles\/nature24042."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1038\/nm.4392","article-title":"GFRAL is the receptor for GDF15 and the ligand promotes weight loss in mice and nonhuman primates","volume":"23","author":"Mullican","year":"2017","journal-title":"Nat. Med."},{"key":"ref_169","unstructured":"(2023, February 13). GFRAL Is the Receptor for GDF15 and Is Required for the Anti-Obesity Effects of the Ligand|Nature Medicine. Available online: https:\/\/www.nature.com\/articles\/nm.4394."},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1038\/nm.4393","article-title":"The metabolic effects of GDF15 are mediated by the orphan receptor GFRAL","volume":"23","author":"Emmerson","year":"2017","journal-title":"Nat. Med."},{"key":"ref_171","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1038\/s41591-020-0945-x","article-title":"Antibody-mediated inhibition of GDF15-GFRAL activity reverses cancer cachexia in mice","volume":"26","author":"Suriben","year":"2020","journal-title":"Nat. Med."},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"111947","DOI":"10.1016\/j.celrep.2022.111947","article-title":"GDF15 neutralization restores muscle function and physical performance in a mouse model of cancer cachexia","volume":"42","author":"Song","year":"2023","journal-title":"Cell Rep."},{"key":"ref_173","unstructured":"(2023, February 13). More Is Better: A Multimodality Approach to Cancer Cachexia\u2014PMC, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3227946\/."},{"key":"ref_174","unstructured":"(2023, February 13). Randomized Phase III Clinical Trial of Five Different Arms of Treatment in 332 Patients with Cancer Cachexia\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/20156909\/."},{"key":"ref_175","unstructured":"(2023, February 13). Insulin Treatment in Cancer Cachexia: Effects on Survival, Metabolism, and Physical Functioning\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/17473202\/."},{"key":"ref_176","unstructured":"(2023, February 13). Effects of Nutrition and Physical Exercise Intervention in Palliative Cancer Patients: A Randomized Controlled Trial\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/28651827\/."},{"key":"ref_177","unstructured":"(2024, February 13). Early Interdisciplinary Supportive Care in Patients with Previously Untreated Metastatic Esophagogastric Cancer: A Phase III Randomized Controlled Trial\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/33417481\/."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/9\/1696\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:34:27Z","timestamp":1760106867000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/9\/1696"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,27]]},"references-count":177,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["cancers16091696"],"URL":"https:\/\/doi.org\/10.3390\/cancers16091696","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,27]]}}}