State-of-the-Art in Cancer Cachexia Diagnostic, Prognostic and Therapy

Dear Colleagues,

During its evolution, cancer induces changes in patients’ energy metabolism that strongly affect the overall clinical state and induce a plethora of symptoms involving various organs and systems (anorexia, nausea, weight loss with reductions in lean mass and adipose tissue, and increased energy metabolism with changes in glucose, lipid, and protein metabolism). These changes are responsible for cancer-related cachexia syndrome—a condition identified by involuntary weight loss accompanied by chronic inflammation. Cancer cachexia has been defined as a “multifactorial syndrome characterized by the ongoing loss of skeletal muscle mass (with or without the loss of fat mass) that cannot be fully reversed by conventional nutritional support”. It is recognized that cancer cachexia syndrome evolves progressively through various stages, from pre-cachexia to cachexia and refractory cachexia. This syndrome affects mainly cancer patients with metastatic disease with a variable incidence among different tumor types and is responsible for about half of all cancer deaths worldwide, although it may be reversible in some phases of neoplastic disease, especially if effective antineoplastic treatments can reduce tumor burden and related catabolic drivers. Despite the strong preclinical and clinical knowledge on the pathogenetic mechanisms of cachexia, tools for early diagnosis and accurate prognostic classification are lacking in clinical practice, and a standardized effective treatment has not yet been established. Meanwhile, based on the relevant clinical impact of this syndrome, a therapeutic approach based on the depth of knowledge of its complex pathogenesis must be implemented. It is therefore mandatory to better understand the mechanisms involved in cachexia, determine its complex clinical picture, and implement the new knowledge to identify it early, define its clinical components properly, and develop targeted and effective therapeutic interventions. Such anticachectic treatments should be based on targeting the complex immunological, inflammatory, and metabolic pathways involved in the complex pathogenesis of cachexia.

For this Special Issue of Cancers, we invite authors to submit contributions that provide novel findings in the field of cancer cachexia, especially in the challenging areas of diagnosis, prognosis, classification, and therapeutic approaches, although other relevant contents will also be considered. We welcome results from the basic research, preclinical, or clinical fields. Reviews that highlight new findings in the areas mentioned above are also welcome.

Prof. Dr. Antonio Maccio
Dr. Silvia Busquets
Dr. Clelia Madeddu
Guest Editors

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• cancer cachexia
• anorexia
• muscle wasting
• adipose tissue
• lipolysis
• energy metabolism
• quality of life
• anticachectic treatment
• fatigue
• prognosis