Cancer Management and Research (Sep 2023)
The Incidence and Management of Cancer-Related Anorexia During Treatment with Vascular Endothelial Growth Factor Receptor-Tyrosine Kinase Inhibitors
Abstract
Shunji Takahashi,1 Koji Matsumoto,2 Kojiro Ohba,3 Yasuhiro Nakano,4 Yasushi Miyazawa,5 Takumi Kawaguchi6 1Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; 2Department of Medical Oncology, Hyogo Cancer Center, Akashi, Japan; 3The Department of Urology and Renal Transplantation, Nagasaki University Hospital, Nagasaki, Japan; 4Department of Pharmacy, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; 5Department of Clinical Nutrition, Tokyo Medical University Hospital, Tokyo, Japan; 6Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, JapanCorrespondence: Shunji Takahashi, Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto, Tokyo, 135-8550, Japan, Tel +81-3-3520-0111, Fax +81-3-3520-0141, Email [email protected]: Cancer-related anorexia is a common complication and frequently occurs in cancer patients treated with vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs). Anorexia contributes to malnutrition, body weight loss, and cachexia in affected patients. Furthermore, patients who experience anorexia have worse outcomes than those who maintain their appetite, highlighting the importance of managing anorexia and related symptoms. However, as the causes of anorexia are both diverse and interconnected, there have been challenges in evaluating and implementing effective interventions. In this review, we described the contributing factors to cancer-related anorexia and reviewed recent literature for the frequency of anorexia symptoms in patients treated with VEGFR-TKIs. Additionally, we evaluated the evidence for current interventions and the potential benefits of multimodal and multidisciplinary approaches to care. The frequency of anorexia symptoms in patients who received VEGFR-TKIs ranged from 14%– 58% for all-grade anorexia and 0%– 6% for grade 3 or 4 anorexia. While many of the interventions for cancer-related anorexia have minimal benefit or adverse events, recent advances in our understanding of cancer-related anorexia suggest that multimodal therapy with multidisciplinary care is a promising avenue of investigation. Several studies currently underway are anticipated to further assess the effectiveness of multimodal approaches.Keywords: appetite, cancer-related anorexia-cachexia syndrome, gastrointestinal symptoms, malnutrition, VEGFR-TKI
