Cancer cachexia—when proteasomal inhibition is not enough

Cachexia is a life threatening syndrome associated with several diseases, such as end-stage heart failure, end-stage renal disease, chronic obstructive pulmonary disease, chronic inflammation (i.e. rheumatoid arthritis), acquired immune deficiency syndrome, and cancer. Cachexia is found in 31-87% of cancer patients especially in advanced disease stages. 5] While patients with non-Hodgkin's lymphoma, breast cancer, and sarcomas show low incidences, rates up to 83% in pancreatic cancer patients, and over 85% in patients with gastric cancer have been found. 8] Therefore, cachexia must be considered as a true multi-organ syndrome. ecause cancer cachexia leads to a decrease in physical performance and quality of life, 11 and is associated with poor survival (accounting for more than 20% of cancer deaths, Even more so since cachectic patients show lower response rates to chemotherapy 7 and a reduced tolerance to anticancer treatment. Despite its importance, weight loss in cancer patients is rarely recognized, assessed, 17 or treated actively. Thus, cancer cachexia represents an important underappreciated clinical syndrome.