Meeting the Amino Acid Requirements for Protein Anabolism in Cancer Cachexia

  • Vickie E. Baracos


A large fraction of patients with advanced cancer develop cachexia [1], a wasting syndrome characterised by anorexia, asthenia, and profound losses of adipose tissue and skeletal muscle mass. The association of cachexia syndrome with poor prognosis, loss of functional status and poor quality of life has motivated researchers to develop therapeutic strategies for this problem [2].


Protein Intake Lean Body Mass Cancer Cachexia Advanced Cancer Patient Limit Amino Acid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Dunlop R (1996) Clinical epidemiology of cancer cachexia. In: Bruera E, Higginson I (eds) CachexiaAnorexia in Cancer Patients. Oxford University Press, Oxford, pp 76–82Google Scholar
  2. 2.
    MacDonald N, Easson NM, Mazurak VC et al (2003) Understanding and managing cancer cachexia. J Am Coll Surg 197:143–161PubMedCrossRefGoogle Scholar
  3. 3.
    Loprinzi CL, Kugler JW, Sloan JA et al (1999) Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol 17:3299–3306PubMedGoogle Scholar
  4. 4.
    Tchekmedyian NS, Hickman M, Siau J et al (1990) Treatment of cancer anorexia with megestrol acetate: impact on quality of life. Oncology 4:185–192PubMedGoogle Scholar
  5. 5.
    Jatoi A, Windschitl HE, Loprinzi CL et al (2002) Donabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. J Clin Oncol 20:567–573PubMedCrossRefGoogle Scholar
  6. 6.
    Timpone JG, Weight DJ, Li N et al (1997) The safety and pharmacokinetics of single-agent and combination therapy with megestrol acetate and dronabinol for the treatment of HIV wasting syndrome. The DATRI 004 study group: division of AIDS treatment research initiative. AIDS Res Hum Retroviruses 13:305–315PubMedCrossRefGoogle Scholar
  7. 7.
    Loprinzi CL, Michalak JC, Schaid DK et al (1993) Phase III evaluation of four doses of megestrol acetate as therapy for patients with cancer anorexia and/or cachexia. J Clin Oncol 11:762–767PubMedGoogle Scholar
  8. 8.
    Bruera E, Ernst S, Hagen N et al (1998) Effectiveness of megestrol acetate in patients with advanced cancer: a randomized, double-blind, crossover study. Cancer Prev Control 2:74–78PubMedGoogle Scholar
  9. 9.
    Bruera E, Macmillan K, Kuehn N et al (1990) A controlled trial of megestrol acetate on appetite, caloric intake, nutritional status, and other symptoms in patients with advanced cancer. Cancer 15:1279–1282CrossRefGoogle Scholar
  10. 10.
    Azcona C, Castro L, Crespo E et al (1996) Megestrol acetate therapy for anorexia and weight loss in children with malignant solid tumors. Aliment Pharmacol Ther 4:577–586CrossRefGoogle Scholar
  11. 11.
    Wigmore SJ, Barber MD, Ross JA et al (2000) Effect of oral eicosapentanoic acid on weight loss in patients with pancreatic cancer. Nutr Cancer 36:177–184PubMedCrossRefGoogle Scholar
  12. 12.
    Barber MD, Ross JA, Voss AC et al (1999) The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer. Br J Cancer 81:80–86PubMedCrossRefGoogle Scholar
  13. 13.
    Burns CP, Halabi S, Clamon GH et al (1999) Phase I clinical study of fish oil fatty acid capsules for patients with cancer cachexia: Cancer and Leukemia Group B Study 9473. Clin Cancer Res 5:3942–3947PubMedGoogle Scholar
  14. 14.
    Bruera E, Strasser F, Palmer JL et al (2003) Effect of fish oil on appetite and other symptoms in patients with advanced cancer and anorexia/cachexia: a double-blind, placebo-controlled study. J Clin Oncol 21:129–134PubMedCrossRefGoogle Scholar
  15. 15.
    Eubanks-May P, Barber A, D’Olimpio J et al (2002) Reversal of cancer-related wasting using oral supplementation with a combination of b-hydroxy-bmethylbutyrate, arginine, and glutamine. Am J Surg 183:471–479CrossRefGoogle Scholar
  16. 16.
    Fearon KC, Von Meyenfeldt MF, Moses AG et al (2003) Effect of a protein and energy dense N-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut 52:1479–1486PubMedCrossRefGoogle Scholar
  17. 17.
    Lundholm K, Daneryd P, Bosaeus I et al (2004) Palliative nutritional intervention in addition to cyclooxygenase and erythropoietin treatment for patients with malignant disease: effects on survival, metabolism and function. Cancer 100:1967–1977PubMedCrossRefGoogle Scholar
  18. 18.
    Mackenzie M, Baracos VE (2003) Cancer-associated cachexia: altered metabolism of protein and amino acids. In: Cynober L (ed) Amino acid metabolism and therapy in health and diseases, 2nd edn. CRC Press, Boca Raton, pp 339–354Google Scholar
  19. 19.
    Brunton JA, Ball RO, Pencharz PB (1998) Determination of amino acid requirements by indicator amino acid oxidation: applications in health and disease. Curr Opin Clin Nutr Metab Care 1:449–453PubMedCrossRefGoogle Scholar
  20. 20.
    Zello GA, Wykes LJ, Ball RO, Pencharz PB (1995) Recent advances in methods of assessing dietary amino acid requirements for adult humans. J Nutr 125:2907–2915PubMedGoogle Scholar
  21. 21.
    Bross R, Ball RO, Pencharz PB (1998) Development of a minimally invasive protocol for the determination of phenylalanine and lysine kinetics in humans during the fed state. J Nutr 128:1913–1919PubMedGoogle Scholar
  22. 22.
    Laurichesse H, Tauveron I, Gourdon F et al (1998) Threonine and methionine are limiting amino acids for protein synthesis in patients with AIDS. J Nutr 128:1342–1348PubMedGoogle Scholar
  23. 23.
    Berard MP, Pelletier A, Ollivier JM et al (2002) Qualitative manipulation of amino acid supply during total parenteral nutrition in surgical patients. JPEN J Parenter Enterai Nutr 26:136–143Google Scholar
  24. 24.
    Martin C (1999) Calorie, protein, fluid and micronutrient requirements. In: McCallum PD, Polisena CG (eds) The clinical guide to oncology nutrition. The American Dietetic Association, Chicago, pp 45–47Google Scholar
  25. 25.
    Millward DJ (2004) Macronutrient intakes as determinants of dietary protein and amino acid adequacy. J Nutr 134(6S):1588S–1596SPubMedGoogle Scholar
  26. 26.
    Millward DJ, Jackson AA (2004) Protein and energy ratios of current diets in developed and developing countries compared with a safe protein:energy ratio: implications for recommended protein and amino acid intakes. Public Health Nutr 7:387–405PubMedCrossRefGoogle Scholar
  27. 27.
    Moses AW, Slater C, Preston T et al (2004) Reduced total energy expenditure and physical activity in cachectic patients with pancreatic cancer can be modulated by an energy and protein dense oral supplement enriched with n-3 fatty acids. Br J Cancer 90:996–1002PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2006

Authors and Affiliations

  • Vickie E. Baracos
    • 1
  1. 1.Department of OncologyUniversity of AlbertaEdmontonCanada

Personalised recommendations