Cancer-associated cachexia (CAC), also known as wasting syndrome, is a systemic condition that affects multiple tissues and organs via a variety of metabolic pathways. Systemic inflammation, progressive weight loss, depletion of adipose tissue, and skeletal muscle impairment are some of the hallmark features of cachexia. Despite various studies on the clinical features of CAC, the complexity of the syndrome continues to pose significant challenges in clinical practice, leading to late diagnoses and the absence of a standardised treatment. Men and women respond differently to CAC, which may be prompted by the pre-existing physiologic sex differences. This review presents the sexual dimorphism associated with the hallmark pathways involved in CAC. A comprehensive understanding of sexual dimorphism in these pathways could drive research on cachexia to prioritise the inclusion of more females in related studies in order to achieve personalised sex-based therapeutic approaches and, consequently, enhance treatment efficacy and better patient outcomes.

The Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplantation: Graft- versus -host disease was approved by Sociedade Brasileira de Transplante de Medula Óssea , with the participation of 26 Brazilian hematopoietic stem cell transplantation centers. It describes the main nutritional protocols in cases of Graft- versus -host disease, the main complication of hematopoietic stem cell transplantation.

Background: Cancer-associated cachexia (CAC) is a multifactorial syndrome driven by a profound metabolic and inflammatory dysregulation. Due to the central role of the insulin-like growth factor 1 (IGF-1) pathway in regulating muscle mass, energy metabolism, and inflammation, this study evaluated the relevance of five IGF-1 axis-related single-nucleotide polymorphisms (SNPs), namely IGF1 rs6220, insulin-like growth factor 1 receptor (IGF1R) rs2016347 and rs2684788, growth hormone receptor (GHR) rs6873545, and insulin receptor substrate 1 (IRS1) rs1801278. Methods: The impact of these variants on CAC onset and overall survival (OS) was assessed in a cohort of 140 cancer patients. Results: While overall-cohort analyses did not reach statistical significance, exploratory analyses suggested potential associations between the IGF1 rs6220 GG and GHR rs6873545 CC genotypes and increased CAC risk in male patients. A trend for higher CAC prevalence was also noted in younger patients (44.2), the IGF1 rs6220 G allele was associated with longer OS. Conversely, the IGF1R rs2016347 G allele and rs2684788 T allele were linked to poorer OS across multiple pre-CAC and CAC subgroups. The effects of GHR rs6873545 varied across subgroups, suggesting context-dependent activity. Conclusions: This study highlights the functional heterogeneity of IGF-1 axis-related genetic variants, indicating potential to serve as predictors of CAC. Given the exploratory nature of these findings, validation in larger cohorts is required to confirm the associations found.

Cancer-associated cachexia (CAC) is a multifactorial syndrome driven by a profound metabolic and inflammatory dysregulation. Due to the central role of the insulin growth factor 1 (IGF-1) pathway in regulating muscle mass, energy metabolism, and inflammation, this study evaluated the relevance of IGF-1 axis-related genetic variants to CAC onset and their impact on overall survival (OS) in a cohort of 140 cancer patients. Five single-nucleotide polymorphisms (SNPs) were evaluated, including IGF1 rs6220, insulin-like growth factor 1 receptor (IGF1R) rs2016347 and rs2684788, growth hormone receptor (GHR) rs6873545 and insulin receptor substrate 1 (IRS1) rs1801278. The IGF1 rs6220 GG and GHR rs6873545 CC genotypes were associated with increased CAC risk in male patients. Younger patients (< 63 years) with the rs6873545 CC genotype also had a higher prevalence of CAC. For pre-CAC and CAC patients, subgroup analyses on patients’ OS were conducted. Among older patients and those with high prognostic nutritional index (PNI; > 44.2), the IGF1 rs6220 G allele was associated with longer OS. Conversely, the IGF1R rs2016347 G allele and rs2684788 T allele were linked to poorer OS across multiple pre-CAC and CAC subgroups. The effects of GHR rs6873545 varied across subgroups, suggesting context-dependent activity. This study highlights the functional heterogeneity of IGF-1 axis-related genetic variants as predictors of CAC development and patient survival. Further validation in larger cohorts is warranted.

The present study aimed to assess the sensitivity of the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scale for scores other than 0 as a screening tool for sarcopenia in onco-hematology patients. A retrospective cohort study of 104 onco-hematology patients aged > 19 years and treated at the Diagnostic and Imaging Center and at an outpatient clinic of a private tertiary hospital was conducted. Sarcopenia was defined as a skeletal muscle index (SMI) of ≤ 38.5 cm²/m² for women and ≤ 52.4 cm²/m² for men based on positron emission tomography-computed tomography scans. Functional status was assessed using an ECOG-PS score of 0 (indicating no dysfunction) or a score of ≥ 1 (indicating dysfunction). Accuracy analysis was conducted to determine the sensitivity and specificity of the ECOG-PS as a screening tool for sarcopenia. Sarcopenia was observed in 57.7% of patients. The median SMI was 43.3 (55.1) kg/m². Sarcopenia diagnosis was positively associated with male sex (p = 0.027) and an ECOG-PS score of ≥ 1 (p = 0.048). As a screening tool for sarcopenia, the ECOG-PS had sensitivity and specificity of 40.7% (95% confidence interval [CI] 30.6–50.8) and 83.8% (95% CI 75.1–92.9), respectively. Sarcopenia is a challenge in cancer. The association of sarcopenia with an ECOG-PS score of ≥ 1 observed in this study reinforces the study hypothesis and importance of further studies on the subject. The current study was approved by the Research Ethics Committee (approval no.: 4.971.257) on September 13, 2021. Owing to the retrospective design study, the respective ethics committee waived the need for the Free and Informed Consent Form. None. TG,: collection and assembly of data, conception and design, data analysis and interpretation, final approval of the manuscript, and writing of the manuscript; TTO, ACLS, and EYHN: conception and design, data analysis and interpretation, final approval of the manuscript, and writing of the manuscript; ALCCR: conception and design, data analysis and interpretation, and and final approval of the manuscript; DSR: collection and assembly of data, data analysis and interpretation, and final approval of the manuscript; TGR: conception and design, data analysis and interpretation, and final approval of the manuscript; LT, YN, and CAR: data analysis and interpretation, final approval of the manuscript, and provision of study materials or patient. 4.971.257. Received: 03 September 2024 Accepted: 25 November 2024 Article published online: 22 May 2025 © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/) Thieme Revinter Publicações Ltda. Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil