Logo image
Review of the endocrine organ–like tumor hypothesis of cancer cachexia in pancreatic ductal adenocarcinoma
Journal article   Open access   Peer reviewed

Review of the endocrine organ–like tumor hypothesis of cancer cachexia in pancreatic ductal adenocarcinoma

Ying-Chun Yu, Azaj Ahmed, Hsueh-Chou Lai, Wei-Chung Cheng, Juan-Chern Yang, Wei-Chun Chang, Lu-Min Chen, Yan-Shen Shan and Wen-Lung Ma
Frontiers in oncology, Vol.12, p.1057930
11/17/2022
DOI: 10.3389/fonc.2022.1057930
PMID: 36465353
url
https://doi.org/10.3389/fonc.2022.1057930View
Published (Version of record) Open Access

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is one of the most fatal types of solid tumors, associated with a high prevalence of cachexia ( 80%). PDAC-derived cachexia (PDAC-CC) is a systemic disease involving the complex interplay between the tumor and multiple organs. The endocrine organ–like tumor (EOLT) hypothesis may explain the systemic crosstalk underlying the deleterious homeostatic shifts that occur in PDAC-CC. Several studies have reported a markedly heterogeneous collection of cachectic mediators, signaling mechanisms, and metabolic pathways, including exocrine pancreatic insufficiency, hormonal disturbance, pro-inflammatory cytokine storm, digestive and tumor-derived factors, and PDAC progression. The complexities of PDAC-CC necessitate a careful review of recent literature summarizing cachectic mediators, corresponding metabolic functions, and the collateral impacts on wasting organs. The EOLT hypothesis suggests that metabolites, genetic instability, and epigenetic changes (microRNAs) are involved in cachexia development. Both tumors and host tissues can secrete multiple cachectic factors (beyond only inflammatory mediators). Some regulatory molecules, metabolites, and microRNAs are tissue-specific, resulting in insufficient energy production to support tumor/cachexia development. Due to these complexities, changes in a single factor can trigger bi-directional feedback circuits that exacerbate PDAC and result in the development of irreversible cachexia. We provide an integrated review based on 267 papers and 20 clinical trials from PubMed and ClinicalTrials.gov database proposed under the EOLT hypothesis that may provide a fundamental understanding of cachexia development and response to current treatments.
Oncology

Details

Metrics

Logo image