Page 81 - ITPS-8-1

INNOSC Theranostics

and Pharmacological Sciences

PERSPECTIVE ARTICLE
Repurposing anabolic agents in cancer

cachexia: A perspective

Charles Paul Lambert*
University of California, San Diego, California, United States of America

Abstract

Cancer cachexia kills millions of people worldwide every decade. Attenuating or
mitigating this muscle-wasting condition associated with cancer could significantly
reduce cancer-related deaths. The drug development pipeline takes 10 – 15 years to
complete in the United States. During this period, hundreds of thousands to millions
worldwide die of cancer cachexia. Medicines already approved by the United States
Food and Drug Administration that cause significant muscle mass gains in healthy
individuals could be used “off-label” or “repurposed” in individuals who do not have
androgen receptor-responsive cancers. These agents are testosterone and anabolic
steroids. In individuals with androgen receptor-responsive tumors, repurposing
anabolic agents (e.g., beta-2 adrenergic agonist albuterol), which increases muscle
mass through different mechanisms than the androgen receptor, is warranted. New
research suggests that phenotyping for the androgen receptor must be conducted
individually, even for the same cancer. The utilization of these two types of anabolic
*Corresponding author: agents – those that use the androgen receptor and those that do not – in appropriate
Charles Paul Lambert clinical trials in cancer cachexia is also warranted.
(lambert600@proton.me)
Citation: Lambert CP. Repurposing
anabolic agents in cancer Keywords: Cancer cachexia; Testosterone; Anabolic steroids; Beta-2 adrenergic agonists;
cachexia: A perspective. INNOSC Prostate cancer; Breast cancer; Androgen receptor
Theranostics and Pharmacological
Sciences. 2025;8(1):75-79.
doi: 10.36922/itps.4699
Received: August 30, 2024 1. Cancer cachexia: Prevalence and mortality
1st revised: October 10, 2024 Cancers are the second leading cause of death in the United States (US), surpassed only
2nd revised: October 22, 2024 by cardiovascular diseases. Approximately 50% of cancer patients suffer from cachexia
1
2
Accepted: October 28, 2024 or disease-related muscle wasting. This definition of cachexia proposed by Evans et al.
is a 5% weight loss in 12 months with an underlying disease, without fluid loss, along
Published online: January 2, 2025
with a loss of muscle mass with or without fat loss, and at least three of the following
Copyright: © 2025 Author(s). five criteria: (i) Decreased muscle strength, (ii) fatigue, (iii) anorexia, (iv) low fat-free
This is an Open-Access article
distributed under the terms of the mass index, and/or (v) abnormal biochemistry results (elevated C-reactive protein and/
Creative Commons Attribution or interleukin-6, anemia, and/or low serum albumin). Different types of cancer, disease
License, permitting distribution, stages, and patient characteristics influence the prevalence of cachexia. Cancer cachexia,
2
and reproduction in any medium,
provided the original work is as defined in clinical practice, varies significantly due to a lack of consensus among
properly cited. physicians and researchers worldwide. Multiple groups have differing definitions of
2-4
Publisher’s Note: AccScience cachexia. However, regardless of the definition of cachexia, the primary concern should
Publishing remains neutral with be the high mortality rates associated with this condition. One challenge in the early
regard to jurisdictional claims in
published maps and institutional and accurate diagnosis of cancer cachexia is the difficulty in obtaining an early diagnosis
affiliations of cancer itself. Additional limitations include the need for specific patient data, such
Volume 8 Issue 1 (2025) 75 doi: 10.36922/itps.4699