Cancer cachexia is now understood to involve adaptations in many different organs and physiological systems. Multiple mechanisms and drivers have been identified that can initiate and sustain the clinical features of cachexia. The multimodal approach to clinical cancer cachexia care recognises that multiple factors can, and usually do, combine to cause cancer cachexia. However, current multimodal models do not go far enough to individualise care and target interventions to maximum effect. One of the biggest challenges in treating patients with cancer cachexia is to identify which are the key driving mechanisms active in each individual and to decide which interventions to use to target these mechanisms. This presentation will describe current understanding of some of the key mechanisms of cancer cachexia. In addition, data from selected recent studies will be presented showing how use of biomarkers may allow better targeting of drug and nutritional interventions for cancer cachexia.
Thomas Jagoe is Director of the McGill Cancer Nutrition Rehabilitation (CNR) Program and medical lead for the CNR clinic at the Jewish General Hospital in Montreal. He trained in Internal Medicine and Pulmonology in the UK and completed a PhD on mechanisms of nutritional depletion in patients with early lung cancer. As a Fulbright Scholar and postdoc in Fred Goldberg's lab at Harvard Medical School (1999-2002) he studied molecular mechanisms of muscle wasting. Using microarrays to identify new genes involved in muscle wasting, including atrogin-1 (Fbxo32), he and colleagues described common transcriptional adaptations shared by different experimental models of muscle wasting. In 2002 Dr Jagoe took up a post as a Senior Lecturer and Clinical Researcher at Liverpool University, UK and in 2007 he moved to Montreal to take over as Director of the McGill CNR program. The CNR clinic uses an integrated multidisciplinary approach to evaluate and treat different aspects of the cachexia syndrome. With members of the CNR team, Dr Jagoe continues to publish research on different aspects of clinical care of patients with cachexia.