3rd Cancer Cachexia Conference: Translating Basic Mechanisms to Therapy

摘要 恶病质是一种使人衰弱的癌症综合征，其特征是主要由于 骨骼肌和脂肪组织的消耗。据估计，80%的癌症患者 这种综合征，20%的癌症死亡是由于恶病质，而不是直接从肿瘤负担。 根据定义，体重减轻> 5%被认为是恶病质，但患者体重减轻20-25%并不罕见。 患病前的体重持续的体重减轻与不良预后有关，恶病质患者 通常虚弱和疲劳，这也降低了他们的生活质量并使护理标准复杂化。营养 干预刺激了患者的一些体重增加，但这种体重主要是以脂肪的形式短暂的， 而瘦肌肉的损失不能逆转。因此，仍然迫切需要发展更多的 有效的恶病质治疗，可以转化为更好的生活质量和改善的结果和生存。作为 这种综合征没有有效的治疗方法，癌症恶病质仍然被认为是一种生命的终结状态 在晚期恶性肿瘤患者中，可以主要通过姑息治疗方法进行管理。 这些和其他意见强调了确定新方法以设计有效 应对这种致命综合症的策略。许多新的治疗癌症的方法 恶病质可能会出现在确定目标，有助于肌肉和脂肪的潜在机制， 损失多年来，确定这些目标的工作肯定有了显著的增长， 重要的是，这些发现中有许多来自进入该领域的新实验室，并发表在 影响力期刊，如Nature，Cell，Nature Medicine和Cell Metabolism。此外， 国家癌症研究所和挑衅性问题机制进一步促进了 从基础和临床两个方面。然而，缺乏一个科学家可以来的论坛， 一起交换意见，讨论最新的未发表的发现。该论坛成立于2012年， 在马萨诸塞州波士顿举行的第一届国际癌症恶病质会议的组织。基于 第一次会议收到的反馈和成功，第二次会议于2014年在 加拿大蒙特利尔。由于登记人数众多，与会者反应热烈， 决定组织第三届国际癌症恶病质会议，这次将在 华盛顿特区。第三次会议的目标是：1）增强对基础知识的理解 癌症恶病质的机制，强调组织之间的串扰和大型数据集的分析; 2)就更有效的临床前和临床试验设计和结局指标的必要性进行教育。 实现这些目标将使该领域处于更有利的地位，以加速抗恶病质的发展 治疗

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.