TẠP CHÍ KHOA HỌC YERSIN
YERSIN JOURNAL OF SCIENCE
ISSN: 2525 - 2372
TẠP CHÍ KHOA HỌC YERSIN
YERSIN JOURNAL OF SCIENCE
Suy mòn ung thư là một tình trạng phổ biến ở bệnh nhân ung thư. Suy mòn ung thư xảy ra ở khoảng 80% bệnh nhân ung thư và là nguyên nhân chính gây tử vong cho khoảng 30% bệnh nhân ung thư, thường là do suy tim hoặc suy hô hấp liên quan đến mất cơ. Các liệu pháp dược lý được đánh giá gồm olanzapine, megestrol acetate, corticosteroid, dronabinol, anamorelin và thuốc ức chế GDF-15. Các nghiên cứu hiện tại cho thấy olanzapine cải thiện cảm giác thèm ăn và tăng cân ở bệnh nhân ung thư, trong khi anamorelin làm tăng khối lượng cơ nạc nhưng không cải thiện sức mạnh cơ bắp. Megestrol acetate và corticosteroid có hiệu quả tương đối hạn chế, trong khi dronabinol gây nhiều tác dụng phụ. Thuốc ức chế GDF-15 tiềm năng cải thiện thể trạng và chất lượng cuộc sống, nhưng cần thêm nghiên cứu để xác nhận hiệu quả. Hiện tại chưa có liệu pháp dược lý nào được Cục quản lý Thực phẩm và Dược phẩm Hoa Kỳ chấp nhận để điều trị suy mòn ung thư, nhấn mạnh tầm quan trọng của phát hiện sớm và can thiệp đa phương thức để giảm thiểu tác động của suy mòn ung thư.
Cancer cachexia is a common condition in cancer patients. Cancer cachexia occurs in approximately 80% of cancer patients and is the leading cause of death in approximately 30% of cancer patients, usually due to cardiac or respiratory failure associated with muscle loss. Pharmacologic therapies evaluated include olanzapine, megestrol acetate, corticosteroids, dronabinol, anamorelin, and GDF-15 inhibitors. Current studies show that olanzapine improves appetite and weight gain in cancer patients, while anamorelin increases lean body mass but does not improve muscle strength. Megestrol acetate and corticosteroids have relatively limited efficacy, while dronabinol causes many side effects. GDF-15 inhibitors have the potential to improve physical function and quality of life, but further studies are needed to confirm their efficacy. There are currently no pharmacologic therapies approved by the US Food and Drug Administration for the treatment of cancer cachexia, emphasizing the importance of early detection and multimodal intervention to minimize the impact of cancer cachexia.
Suy mòn, suy mòn ung thư, ung thư, chăm sóc giảm nhẹ, olanzapin
Cachexia, cancer cachexia, cancer, palliative care, olanzapine
Abrams, D. I. (2016). Integrating cannabis into clinical cancer care. Curr Oncol, 23(2), S8-s14. doi:10.3747/co.23.3099
Albano, D., Benenati, M., Bruno, A., Bruno, F., Calandri, M., Caruso, D., . . . Messina, C. (2021). Imaging side effects and complications of chemotherapy and radiation therapy: a pictorial review from head to toe. Insights Imaging, 12(1), 76. doi:10.1186/s13244-021-01017-2
AminiLari, M., Wang, L., Neumark, S., Adli, T., Couban, R. J., Giangregorio, A., . . . Busse, J. W. (2022). Medical cannabis and cannabinoids for impaired sleep: a systematic review and meta-analysis of randomized clinical trials. Sleep, 45(2). doi:10.1093/sleep/zsab234
Arends, J., Strasser, F., Gonella, S., Solheim, T. S., Madeddu, C., Ravasco, P., . . . Ripamonti, C. I. (2021). Cancer cachexia in adult patients: ESMO Clinical Practice Guidelines. ESMO Open, 6(3). doi:10.1016/j.esmoop.2021.100092
Baracos, V. E., Martin, L., Korc, M., Guttridge, D. C., & Fearon, K. C. H. (2018). Cancer-associated cachexia. Nat Rev Dis Primers, 4, 17105. doi:10.1038/nrdp.2017.105
Beltrà, M., Pin, F., Ballarò, R., Costelli, P., & Penna, F. (2021). Mitochondrial Dysfunction in Cancer Cachexia: Impact on Muscle Health and Regeneration. Cells, 10(11). doi:10.3390/cells10113150
Bonomi, P. D., Walsh, D., Currow, D. C., Ballinari, G., & Skipworth, R. J. E. (2022). Cancer cachexia impact on chemotherapy dose reduction, treatment discontinuation, and survival: A qualitative systematic review. Journal of Clinical Oncology, 40(16_suppl), e24103-e24103. doi:10.1200/JCO.2022.40.16_suppl.e24103
Braun, I. M., Bohlke, K., Abrams, D. I., Anderson, H., Balneaves, L. G., Bar-Sela, G., . . . Roeland, E. J. (2024). Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline. Journal of Clinical Oncology, 42(13), 1575-1593. doi:10.1200/JCO.23.02596
Breen, D. M., Kim, H., Bennett, D., Calle, R. A., Collins, S., Esquejo, R. M., . . . Birnbaum, M. J. (2020). GDF-15 Neutralization Alleviates Platinum-Based Chemotherapy-Induced Emesis, Anorexia, and Weight Loss in Mice and Nonhuman Primates. Cell Metab, 32(6), 938-950.e936. doi:10.1016/j.cmet.2020.10.023
Breit, S. N., Brown, D. A., & Tsai, V. W. (2021). The GDF15-GFRAL Pathway in Health and Metabolic Disease: Friend or Foe? Annu Rev Physiol, 83, 127-151. doi:10.1146/annurev-physiol-022020-045449
Cancer Research UK. (2023). Cachexia (wasting syndrome).
Castellano, D., Sepulveda, J. M., García-Escobar, I., Rodriguez-Antolín, A., Sundlöv, A., & Cortes-Funes, H. (2011). The role of RANK-ligand inhibition in cancer: the story of denosumab. Oncologist, 16(2), 136-145. doi:10.1634/theoncologist.2010-0154
Crawford, J., Calle, R. A., Collins, S. M., Weng, Y., Lubaczewski, S. L., Buckeridge, C., . . . Revkin, J. H. (2024). A Phase Ib First-In-Patient Study Assessing the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Ponsegromab in Participants with Cancer and Cachexia. Clin Cancer Res, 30(3), 489-497. doi:10.1158/1078-0432.ccr-23-1631
Crawford, J., Lubaczewski, S. L., Tarachandani, A., Harrington, M. A., Weng, Y., Qiu, R., . . . Revkin, J. H. (2023). Phase 2 study to assess the efficacy, safety, and tolerability of the GDF-15 inhibitor ponsegromab in patients with cancer cachexia. Journal of Clinical Oncology, 41(16_suppl), TPS12147-TPS12147. doi:10.1200/JCO.2023.41.16_suppl.TPS12147
Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., . . . Zamboni, M. (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing, 48(1), 16-31. doi:10.1093/ageing/afy169
Currow, D., Temel, J. S., Abernethy, A., Milanowski, J., Friend, J., & Fearon, K. C. (2017). ROMANA 3: a phase 3 safety extension study of anamorelin in advanced non-small-cell lung cancer (NSCLC) patients with cachexia. Ann Oncol, 28(8), 1949-1956. doi:10.1093/annonc/mdx192
Davis, M. P., & Sanger, G. J. (2020). The Benefits of Olanzapine in Palliating Symptoms. Curr Treat Options Oncol, 22(1), 5. doi:10.1007/s11864-020-00804-1
Dev, R., Bruera, E., & Dalal, S. (2018). Insulin resistance and body composition in cancer patients. Ann Oncol, 29(suppl_2), ii18-ii26. doi:10.1093/annonc/mdx815
Dev, R., Fortuno, E. S., 3rd, Amaram-Davila, J. S., Haider, A., & Bruera, E. (2023). Benefits and risks of off-label olanzapine use for symptom management in cancer patients-a case report. Ann Palliat Med, 12(3), 600-606. doi:10.21037/apm-22-1167
Dufresne, S. S., Dumont, N. A., Boulanger-Piette, A., Fajardo, V. A., Gamu, D., Kake-Guena, S. A., . . . Frenette, J. (2016). Muscle RANK is a key regulator of Ca2+ storage, SERCA activity, and function of fast-twitch skeletal muscles. Am J Physiol Cell Physiol, 310(8), C663-672. doi:10.1152/ajpcell.00285.2015
Engineer, D. R., & Garcia, J. M. (2012). Leptin in anorexia and cachexia syndrome. Int J Pept, 2012, 287457. doi:10.1155/2012/287457
Fearon, K., Argiles, J. M., Baracos, V. E., Bernabei, R., Coats, A., Crawford, J., . . . Anker, S. D. (2015). Request for regulatory guidance for cancer cachexia intervention trials. J Cachexia Sarcopenia Muscle, 6(4), 272-274. doi:10.1002/jcsm.12083
Fearon, K., Strasser, F., Anker, S. D., Bosaeus, I., Bruera, E., Fainsinger, R. L., . . . Baracos, V. E. (2011). Definition and classification of cancer cachexia: an international consensus. Lancet Oncol, 12(5), 489-495. doi:10.1016/s1470-2045(10)70218-7
Grivennikov, S. I., Greten, F. R., & Karin, M. (2010). Immunity, inflammation, and cancer. Cell, 140(6), 883-899. doi:10.1016/j.cell.2010.01.025
Herremans, K. M., Riner, A. N., Cameron, M. E., & Trevino, J. G. (2019). The Microbiota and Cancer Cachexia. Int J Mol Sci, 20(24). doi:10.3390/ijms20246267
Khatib, M. N., Shankar, A. H., Kirubakaran, R., Gaidhane, A., Gaidhane, S., Simkhada, P., & Quazi Syed, Z. (2018). Ghrelin for the management of cachexia associated with cancer. Cochrane Database Syst Rev, 2(2), Cd012229. doi:10.1002/14651858.CD012229.pub2
Kim-Muller, J. Y., Song, L., LaCarubba Paulhus, B., Pashos, E., Li, X., Rinaldi, A., . . . Zhang, B. B. (2023). GDF15 neutralization restores muscle function and physical performance in a mouse model of cancer cachexia. Cell Rep, 42(1), 111947. doi:10.1016/j.celrep.2022.111947
Kurzrock, R. (2001). The role of cytokines in cancer-related fatigue. Cancer, 92(6 Suppl), 1684-1688. doi:10.1002/1097-0142(20010915)92:6+<1684::aid-cncr1497>3.0.co;2-z
Li, Y., Jiang, Q., & Wang, L. (2021). Appetite Regulation of TLR4-Induced Inflammatory Signaling. Front Endocrinol (Lausanne), 12, 777997. doi:10.3389/fendo.2021.777997
Lim, S., Brown, J. L., Washington, T. A., & Greene, N. P. (2020). Development and progression of cancer cachexia: Perspectives from bench to bedside. Sports Med Health Sci, 2(4), 177-185. doi:10.1016/j.smhs.2020.10.003
Lim, Y. L., Teoh, S. E., Yaow, C. Y. L., Lin, D. J., Masuda, Y., Han, M. X., . . . Ng, Q. X. (2022). A Systematic Review and Meta-Analysis of the Clinical Use of Megestrol Acetate for Cancer-Related Anorexia/Cachexia. J Clin Med, 11(13). doi:10.3390/jcm11133756
Locchi, F., Dall'olio, R., Gandolfi, O., & Rimondini, R. (2008). Olanzapine counteracts stress-induced anxiety-like behavior in rats. Neurosci Lett, 438(2), 146-149. doi:10.1016/j.neulet.2008.04.017
Lockington, M. R., & Hughes, R. N. (2021). Effects of olanzapine on anxiety-related behaviour in male and female rats assessed after 21-24 and 42-45 days of chronic treatment. Behav Pharmacol, 32(2&3), 194-211. doi:10.1097/fbp.0000000000000612
Loprinzi, C. L., Kugler, J. W., Sloan, J. A., Mailliard, J. A., Krook, J. E., Wilwerding, M. B., . . . Christensen, B. J. (1999). Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol, 17(10), 3299-3306. doi:10.1200/jco.1999.17.10.3299
Loprinzi, C. L., Schaid, D. J., Dose, A. M., Burnham, N. L., & Jensen, M. D. (1993). Body-composition changes in patients who gain weight while receiving megestrol acetate. J Clin Oncol, 11(1), 152-154. doi:10.1200/jco.1993.11.1.152
Mantovani, G., Macciò, A., Lai, P., Massa, E., Ghiani, M., & Santona, M. C. (1998). Cytokine involvement in cancer anorexia/cachexia: role of megestrol acetate and medroxyprogesterone acetate on cytokine downregulation and improvement of clinical symptoms. Crit Rev Oncog, 9(2), 99-106. doi:10.1615/critrevoncog.v9.i2.10
Martin, A., & Freyssenet, D. (2021). Phenotypic features of cancer cachexia-related loss of skeletal muscle mass and function: lessons from human and animal studies. J Cachexia Sarcopenia Muscle, 12(2), 252-273. doi:10.1002/jcsm.12678
Martin, L., Senesse, P., Gioulbasanis, I., Antoun, S., Bozzetti, F., Deans, C., . . . Baracos, V. E. (2015). Diagnostic criteria for the classification of cancer-associated weight loss. J Clin Oncol, 33(1), 90-99. doi:10.1200/jco.2014.56.1894
Narang, S., Gibson, D., Wasan, A. D., Ross, E. L., Michna, E., Nedeljkovic, S. S., & Jamison, R. N. (2008). Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy. J Pain, 9(3), 254-264. doi:10.1016/j.jpain.2007.10.018
National Cancer Institute. (2022). Cancer Cachexia: After Years of No Advances, Progress Looks Possible.
National Cancer Institute. (2024). Nausea and Vomiting and Cancer Treatment.
Navari, R. M., & Brenner, M. C. (2010). Treatment of cancer-related anorexia with olanzapine and megestrol acetate: a randomized trial. Support Care Cancer, 18(8), 951-956. doi:10.1007/s00520-009-0739-7
Ng, S. K., Chung, D. J., Chang, L. C., Luo, C. K., Jwo, S. H., Lee, Y. H., . . . Wei, T. T. (2023). The protective effect of cannabinoids against colorectal cancer cachexia through modulation of inflammation and immune responses. Biomed Pharmacother, 161, 114467. doi:10.1016/j.biopha.2023.114467
Nipp, R. D., Fuchs, G., El-Jawahri, A., Mario, J., Troschel, F. M., Greer, J. A., . . . Fintelmann, F. J. (2018). Sarcopenia Is Associated with Quality of Life and Depression in Patients with Advanced Cancer. Oncologist, 23(1), 97-104. doi:10.1634/theoncologist.2017-0255
Pin, F., Jones, A. J., Huot, J. R., Narasimhan, A., Zimmers, T. A., Bonewald, L. F., & Bonetto, A. (2022). RANKL Blockade Reduces Cachexia and Bone Loss Induced by Non-Metastatic Ovarian Cancer in Mice. J Bone Miner Res, 37(3), 381-396. doi:10.1002/jbmr.4480
Pofi, R., Caratti, G., Ray, D. W., & Tomlinson, J. W. (2023). Treating the Side Effects of Exogenous Glucocorticoids; Can We Separate the Good From the Bad? Endocr Rev, 44(6), 975-1011. doi:10.1210/endrev/bnad016
Rhondali, W., Chisholm, G. B., Daneshmand, M., Allo, J., Kang, D. H., Filbet, M., . . . Bruera, E. (2013). Association between body image dissatisfaction and weight loss among patients with advanced cancer and their caregivers: a preliminary report. J Pain Symptom Manage, 45(6), 1039-1049. doi:10.1016/j.jpainsymman.2012.06.013
Rivas, A. S., Álvarez, Y. E., Cordellat, A. B., Tarruella, M. M., Mata, K. M., de la Cámara, M. M., . . . Gutierrez, L. C. (2024). SEOM clinical guidelines for cancer anorexia-cachexia syndrome (2023). Clinical and Translational Oncology. doi:10.1007/s12094-024-03502-8
Rodríguez-Nava, C., Ortuño-Pineda, C., Illades-Aguiar, B., Flores-Alfaro, E., Leyva-Vázquez, M. A., Parra-Rojas, I., . . . Alarcón-Romero, L. D. (2023). Mechanisms of Action and Limitations of Monoclonal Antibodies and Single Chain Fragment Variable (scFv) in the Treatment of Cancer. Biomedicines, 11(6). Retrieved from doi:10.3390/biomedicines11061610
Roeland, E. J., Bohlke, K., Baracos, V. E., Bruera, E., del Fabbro, E., Dixon, S., . . . Loprinzi, C. L. (2020). Management of Cancer Cachexia: ASCO Guideline. Journal of Clinical Oncology, 38(21), 2438-2453. doi:10.1200/JCO.20.00611
Roeland, E. J., Bohlke, K., Baracos, V. E., Smith, T. J., Loprinzi, C. L., Bruera, E., . . . Tan, W. (2023). Cancer Cachexia: ASCO Guideline Rapid Recommendation Update. Journal of Clinical Oncology, 41(25), 4178-4179. doi:10.1200/JCO.23.01280
Ruiz-García, V., López-Briz, E., Carbonell-Sanchis, R., Bort-Martí, S., & Gonzálvez-Perales, J. L. (2018). Megestrol acetate for cachexia-anorexia syndrome. A systematic review. J Cachexia Sarcopenia Muscle, 9(3), 444-452. doi:10.1002/jcsm.12292
Sandhya, L., Devi Sreenivasan, N., Goenka, L., Dubashi, B., Kayal, S., Solaiappan, M., . . . Ganesan, P. (2023). Randomized Double-Blind Placebo-Controlled Study of Olanzapine for Chemotherapy-Related Anorexia in Patients With Locally Advanced or Metastatic Gastric, Hepatopancreaticobiliary, and Lung Cancer. J Clin Oncol, 41(14), 2617-2627. doi:10.1200/jco.22.01997
Simon, L., Baldwin, C., Kalea, A. Z., & Slee, A. (2022). Cannabinoid interventions for improving cachexia outcomes in cancer: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle, 13(1), 23-41. doi:10.1002/jcsm.12861
Sophie Wedekind, & Cancer Research UK. (2023). Wasting syndrome: What is cachexia?
Suriben, R., Chen, M., Higbee, J., Oeffinger, J., Ventura, R., Li, B., . . . Allan, B. B. (2020). Antibody-mediated inhibition of GDF15–GFRAL activity reverses cancer cachexia in mice. Nature Medicine, 26(8), 1264-1270. doi:10.1038/s41591-020-0945-x
Wakabayashi, H., Arai, H., & Inui, A. (2021). The regulatory approval of anamorelin for treatment of cachexia in patients with non-small cell lung cancer, gastric cancer, pancreatic cancer, and colorectal cancer in Japan: facts and numbers. J Cachexia Sarcopenia Muscle, 12(1), 14-16. doi:https://doi.org/10.1002/jcsm.12675
Yu, Y., Tsang, Q. K., Jaramillo-Polanco, J., Lomax, A. E., Vanner, S. J., & Reed, D. E. (2022). Cannabinoid 1 and mu-Opioid Receptor Agonists Synergistically Inhibit Abdominal Pain and Lack Side Effects in Mice. J Neurosci, 42(33), 6313-6324. doi:10.1523/jneurosci.0641-22.2022
Zhang, Y., Shi, G., Zhang, H., Xiong, Q., Cheng, F., Wang, H., . . . Deng, H. (2021). Dexamethasone enhances the lung metastasis of breast cancer via a PI3K-SGK1-CTGF pathway. Oncogene, 40(35), 5367-5378. doi:10.1038/s41388-021-01944-w
Zhao, H., Wu, L., Yan, G., Chen, Y., Zhou, M., Wu, Y., & Li, Y. (2021). Inflammation and tumor progression: signaling pathways and targeted intervention. Signal Transduct Target Ther, 6(1), 263. doi:10.1038/s41392-021-00658-5