Please use this identifier to cite or link to this item: https://doi.org/10.1111/apha.13516
Title: Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass
Authors: Looijaard, Stephanie MLM
Hekkert, Miriam L te Lintel
Wust, Rob C
Otten, Rene HJ
Meskers, Carel GM
Maier, Andrea B 
Keywords: Science & Technology
Life Sciences & Biomedicine
Physiology
aged
cachexia
geriatric oncology
neoplasms
physiopathology
sarcopenia
CIRCULATING MITOCHONDRIAL-DNA
INDEPENDENT PROGNOSTIC-FACTOR
GUT BARRIER DYSFUNCTION
NATURAL-KILLER-CELLS
BODY-SURFACE AREA
INSULIN-RESISTANCE
COLORECTAL-CANCER
SARCOPENIC OBESITY
PROTEIN-SYNTHESIS
NATIONAL-HEALTH
Issue Date: 24-Jul-2020
Publisher: WILEY
Citation: Looijaard, Stephanie MLM, Hekkert, Miriam L te Lintel, Wust, Rob C, Otten, Rene HJ, Meskers, Carel GM, Maier, Andrea B (2020-07-24). Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass. ACTA PHYSIOLOGICA 231 (1). ScholarBank@NUS Repository. https://doi.org/10.1111/apha.13516
Abstract: Low skeletal muscle mass is highly prevalent in older cancer patients and affects 5% to 89% depending on the type and stage of cancer. Low skeletal muscle mass is associated with poor clinical outcomes such as post-operative complications, chemotherapy toxicity and mortality in older cancer patients. Little is known about the mediating pathophysiological mechanisms. In this review, we summarize proposed pathophysiological mechanisms underlying the association between low skeletal muscle mass and poor clinical outcomes in older cancer patients including a) systemic inflammation; b) insulin-dependent glucose handling; c) mitochondrial function; d) protein status and; e) pharmacokinetics of anticancer drugs. The mechanisms of altered myokine balance negatively affecting the innate and adaptive immune system, and altered pharmacokinetics of anticancer drugs leading to a relative overdosage of anticancer drugs are best-substantiated. The effects of glucose intolerance and circulating mitochondrial DNA as a consequence of low skeletal muscle mass are topics of interest for future research. Restoring myokine balance through physical exercise, exercise mimetics, neuro-muscular activation and adapting anticancer drug dosing on skeletal muscle mass could be targeted approaches to improve clinical outcomes in older cancer patients with low skeletal muscle mass.
Source Title: ACTA PHYSIOLOGICA
URI: https://scholarbank.nus.edu.sg/handle/10635/234898
ISSN: 1748-1708
1748-1716
DOI: 10.1111/apha.13516
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