3rd Cancer Cachexia Conference: Translating Basic Mechanisms to Therapy

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ABSTRACT Cachexia is a debilitating syndrome of cancer, characterized by involuntary weight loss resulting mainly from the depletion of skeletal muscle and adipose tissue. Estimates suggest that up to 80% of all cancers present with this syndrome, and 20% of cancer deaths are due to cachexia rather than directly from the tumor burden. By definition, weight loss > 5% is considered cachectic, but it is not uncommon for patients to lose 20-25% of their pre-illness weight. Continual weight loss associates with a poor prognosis and cachexia patients are typically weak and fatigue, which also lowers their quality of life and complicates standard of care. Nutritional interventions stimulate some weight gain in patients, but this weight is mostly transient in the form of adipose, while the loss of lean muscle cannot be reversed. Therefore, there remains an urgent need to develop more effective cachexia therapies that can translate to a better quality of life and improved outcome and survival. As there is no effective cure for this syndrome, cancer cachexia remains largely viewed as an end-of-life condition in patients with advanced malignancies that can be managed primarily through palliative care approaches. These and other observations underscore the importance of identifying new methods for the design of effective strategies to combat this deadly syndrome. Many of the new therapies that will be developed for cancer cachexia will likely come on identifying targets that contribute to the underlying mechanisms of muscle and fat loss. Over the years, there has certainly been significant growth in the identification of these targets, and importantly, a number of these discoveries have come from new laboratories entering the field and published in impact journals such as Nature, Cell, Nature Medicine, and Cell Metabolism. In addition, support from the National Institutes of Cancer and the Provocative Questions mechanism further contributed to the expansion of the field from both the basic and clinical side. Lacking however was a forum where scientist could come together to exchange ideas and discuss the latest unpublished findings. This forum was created in 2012 with the organization of the 1st International Cancer Cachexia conference held in Boston, Massachusetts. Based on the feedback received and the successes of this first meeting, a 2nd conference was organized in 2014 in Montreal, Canada. With strong registration numbers and enthusiastic responses from those who attended, the decision was made to organize the 3rd International Cancer Cachexia Conference that this time will be held in Washington DC. The goals of this third conference is to 1) enhance the understanding of the underlying mechanisms of cancer cachexia, emphasizing cross talk between tissues and analysis of large data sets; and 2) to educate on the need for better effective pre-clinical and clinical trial design and outcome measures. Achieving these goals will place the field in a better position to accelerate the development of anti-cachexia therapies.