研究动态
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肥胖对癌症治疗的有效性和结果的多因素影响。

The multifactorial effect of obesity on the effectiveness and outcomes of cancer therapies.

发表日期:2024 Sep 23
作者: Joanne Lysaght, Melissa J Conroy
来源: Nature Reviews Endocrinology

摘要:

流行病学研究表明,肥胖与几种不同恶性肿瘤的发展之间存在明显的关联,内脏过度肥胖是接受治疗干预的癌症患者日益普遍的特征。临床试验和荟萃分析有助于为患有癌症和肥胖的成年患者提供传统全身性抗癌药物的有效和安全剂量的信息,但仍然存在很多争论,不仅涉及肥胖对更新颖的靶向分子和免疫疗法的影响。疗法,还包括如何在临床上最好地定义和测量肥胖。低肌肉质量与癌症的不良结果相关,使用生化和成像方式的身体成分研究有助于充分描述肥胖和肌肉减少症在临床结果中的重要性;此类研究也可能在某种程度上解释肥胖如何与某些癌症的良好临床结果矛盾地相关。随着癌症生存期的延长和抗癌治疗持续时间的延长,本综述强调了选择适当的治疗方法所面临的挑战,并强调了如何需要采取多学科方法来控制癌症治疗期间和治疗后的体重和骨骼肌损失。© 2024。Springer Nature Limited 。
Epidemiology studies have demonstrated a clear association between obesity and the development of several distinct malignancies, with excessive visceral adiposity being an increasingly prevalent feature in patients with cancer presenting for therapeutic intervention. Clinical trials and meta-analyses have helped to inform effective and safe dosing of traditional systemically administered anticancer agents in adult patients with cancer and obesity, but there remains much debate not only regarding the effect of obesity on the more novel targeted molecular and immune-based therapies, but also about how obesity is best defined and measured clinically. Low muscle mass is associated with poor outcomes in cancer, and body composition studies using biochemical and imaging modalities are helping to fully delineate the importance of both obesity and sarcopenia in clinical outcomes; such studies might also go some way to explaining how obesity can paradoxically be associated with favourable clinical outcomes in certain cancers. As the cancer survivorship period increases and the duration of anticancer treatment lengthens, this Review highlights the challenges facing appropriate treatment selection and emphasizes how a multidisciplinary approach is warranted to manage weight and skeletal muscle loss during and after cancer treatment.© 2024. Springer Nature Limited.