# The Role of New Agents and Supportive Care in a Multimodal Approach to Cancer Cachexia

## TL;DR

This paper discusses new treatments and supportive care for cancer cachexia, a condition causing weight loss and poor quality of life in cancer patients.

## Contribution

The paper highlights new agents showing promise in phase II trials and the potential for multimodal treatment approaches.

## Key findings

- New agents targeting mechanisms like food aversion and catabolism show efficacy and tolerability in early trials.
- Combining pharmacologic treatments with supportive care may improve outcomes for cancer cachexia patients.
- Upcoming multi-center trials will determine the effectiveness of these new agents and combination therapies.

## Abstract

There is an unmet need for effective treatments in patients with cancer cachexia. Patients suffering from cachexia endure weight loss, fatigue, poor appetite, a diminished quality of life and decreased survival. There are no medications approved for this condition in North America or Europe. Fortunately, several recent studies show that effective treatments improve appetite and are well tolerated with few side effects. These treatments will be evaluated in large multi-center trials within the next year. In future, these medications may prove to be even more effective when combined, or added to supportive care measures such as nutrition, exercise, and psychological counseling.

Given the multi-faceted nature of cancer cachexia, a combination of pharmacologic and supportive measures such as exercise and nutrition seems intuitive to most clinicians. Clinical trials have also suggested that a multimodal approach to cancer cachexia (CC) is feasible and potentially effective. However, past trials have been limited by medications that were partially effective or had the potential for serious adverse events such as thromboembolism. We review new agents that have demonstrated efficacy in phase II trials or are involved in multi-center phase III studies. The advent of several recent phase II studies indicate that consistently effective, well-tolerated medications may soon be available for CC. These new agents target several mechanisms involved in CC, including food aversion, catabolism, and decreased anabolism. Several multi-center studies are expected to be actively recruiting this year. If these agents prove to be effective, individualized treatment may be possible, guided by individuals’ phenotype and/or clinical biomarkers. Future research should also determine whether combination therapy (pharmacologic and/or non-pharmacologic) produces additive or synergistic benefits.