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Various anti Cachexia drugs and supplements

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Dietary supplements in the treatment of cancer cachexia

Agent Mechanism of action Ref.
N3-fatty acids (EPA, DHA, fish oil) Reduction of pro-inflammatory cytokines and acute-phase-response [32-36]
L-Carnitine Antioxidant, cofactor of mitochondrial production of Acetyl-coA (ß-oxidation, aminoacid metabolism) [37-40]
Antioxidants (GSH, ALA, NAC, vitamins A/C/E) Reduction of ROS-formation and oxidative stress [42-45]
Branched-chain-amino acids Anabolic effects, stimulation of appetite and food intake [46-49]
Lactoferrin Increase of hemoglobin in anemic patients, iron-metabolism, decrease of inflammatory response [50]


Pharmacological treatment approaches for cancer cachexia

  Agent Mechanism of action Ref.
Potentially effective therapies Progesterone Appetite stimulation through neuropeptide y [59,61,90-92]
(MA, MPA) down-regulation of pro-inflammatory cytokines
Corticosteroids Inhibition of prostaglandin activity, suppression of IL-1 and TNF-α [62]
Anabolic androgens Muscle anabolism, up-regulation of protein synthesis, dose-dependent alterations of Akt-phosphorylation, GLUT-4 and ISR-expression [64,65]
SARMs Selective modulation of androgen receptors in muscle tissue only [67-69]
Experimental therapies NSAIDs Inhibition of COX-1 and -2 prostaglandin-synthesis, decrease of inflammatory reaction [71,72]
COX-2 selective inhibitors Inhibition of prostaglandin-synthesis, decrease of inflammatory reaction, additional antineoplastic and anti-angiogenetic effects [70,73,92]
Thalidomide Inhibition of TNF-α, and other pro-inflammatory cytokines, NF-κB, inhibition of COX-2 [74-76]
Anti-TNF mAb Inhibition of TNF-α [78,79]
Anti-IL-6 mAb Inhibition of IL-6 [85]
ACE-Inhibitors Inhibition of angiotensin converting enzyme, role in cancer cachexia not yet fully understood [88,89]
Myostatin-inhibitors/ActIIrb-antagonists Inhibition of ActIIrb signaling, stimulation of muscle growth and regeneration [4,66,86,87]
Ghrelin/Ghrelin mimetics Stimulation of GH-secretion, appetite stimulation though neuropeptide y, decrease of sympathetic nerve activity [54-57]
Mirtazepin, Olanzapine Appetite stimulation through serotonergic blockade [58,59]
Treatments without proven effectiveness Pentoxifylline Inhibition of TNF-α [77]
Insulin, IGF-1, GH Regulation of body composition (fat, glucose and protein metabolism) via PI3K/Akt-, MAPK-pathways [63,64,95]
Cannaboids (dronabinol) Appetite stimulation, energy hemostasis [53]