vitro production of cytokines and serotonin by peripheral blood mononuclear cells of cancer patients; both of these agents reduce the cisplatin-induced serotonin release in vitro from peripheral blood mononuclear cells of cancer patients (Mantovani et al., 1998).

Another promising area in basic research on cachexia is related to the recent identification of peptides involved in food regulatory systems, including the hormone leptin and leptin receptors, uncoupling proteins, agouti protein, melanocortin receptor isoforms, melanin-concentrating hormone, and the proteins responsible for “tub” and “fat” (mouse models of obesity) (Bessesen and Faggioni, 1998).

Basic Research Needs

Major questions for basic research include the following:

  1. What are the specific roles of various cytokines in the cachectic process?

  2. What are the roles of the food regulatory peptides in the cachectic process?

Clinical Research Needs

Clinical trials should focus on the following types of drugs:

  1. proinflammatory mediators;

  2. appetite stimulants;

  3. anticatabolic agents (e.g., neuropeptide agonists and antagonists, beta 2- adrenoceptor agonists);

  4. polyunsaturated fatty acids, n- [omega-] 3 fatty acids, fish oil;

  5. anabolic agents (especially hormonal); and

  6. anticytokines (e.g., megestrol acetate, medroxyprogesterone acetate, thalidomide, melatonin).

Review of Current Funding: CRISP Listings

Searching the CRISP database of current federal funding using the terms cancer and cachexia produced 28 hits. Inspection of the result found a total of 10 that relate to basic or clinical research possibly relevant to clinical cancer cachexia. Of these studies, none are descriptive (including correlational and behavioral studies), two deal with trials of interventions, and eight are basic science studies.

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