Abstract

Cancer anorexia-cachexia syndrome (CACS) is a very severe complication of cancer for which an adequate therapeutic strategy has not yet been defined. Recently, a notable number of new animal models of human CACS has been made available for translational purposes. Under the assumption that tumor-induced adaptations of host metabolism and tumor-host energetic competition play a major role in CACS (together with possible toxicities induced by the anticancer treatment), we developed a new Dynamic Energy Budget (DEB)-based framework, modeling tumor-in-host growth dynamics and cachexia onset in preclinical animal models during anticancer treatments. The tumor-in-host modeling approach was successfully applied on a multitude of in vivo preclinical studies involving different host species, tumor cell lines, type of anticancer agents and experimental settings among which standard xenograft studies. Obtained results strongly suggested the adoption of the tumor-in-host DEB-based approach in the preclinical oncological setting for a joint assessment of drug efficacy and toxicity and for a better design of the experiments. Further applications of the DEB-based approach to the context of poly-targeted combination therapy, anti-cachectic treatments and preclinical to clinical translation are under investigation with extremely encouraging preliminary results.

Highlights

  • Cancer anorexia-cachexia syndrome (CACS) is a very severe complication of cancer that affects the majority of cancer patients and it is responsible of 20% of their death [1]

  • The pathophysiology of cachexia is characterized by a negative energy and protein balance that is driven by a combination of starvation and abnormal metabolism, seemingly induced by multiple factors related to both tumor progression and drug toxic effects [1, 3]

  • This opened a debate about the availability of appropriate in vivo preclinical models [6] and in the recent years a notable number of new animal models of human CACS that may be useful to circumvent the clinical limitations, expand understanding of underlying pathogenic mechanisms and explore the effectiveness of prospective treatments for translational purposes, have been developed [7,8,9]

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Summary

Introduction

Cancer anorexia-cachexia syndrome (CACS) is a very severe complication of cancer that affects the majority of cancer patients and it is responsible of 20% of their death [1]. This editorial aims to summarize the research that in the last 7–8 years has led to the development of a new DEB-based framework modeling the tumor-in-host growth dynamics and the cachexia onset in preclinical animal models during anticancer treatments [14,15,16].

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