Anorexia-cachexia syndrome in pancreatic cancer: recent development in research and management.

Despite more than 30 years of clinical trials, the cure rate for pancreatic cancer remains less than 5% and the yearly incidence rate of this tumor virtually overlaps the mortality rate [1]. Only a small portion of patients presents potentially resectable disease but even for the patients undergoing a “curative” pancreaticoduodenectomy, the five-year survival rate remains very poor. Close to 100% of patients with pancreatic cancer develop metastases and die from the debilitating metabolic effects of their unrestrained growth; the actual median survival rate for patients with advanced disease is a dismal 3 to 6 months [2]. Compared to other tumors, pancreatic cancer has the highest incidence of cachexia reaching as much as 80% at the time of diagnosis [3, 4]; as a consequence, palliation of this occurrence remains one the most important therapeutic targets in clinical practice. Over the last few years, important new developments regarding the pathogenesis of pancreatic cancer cachexia have been achieved; unfortunately, these insights into the mechanisms of pancreatic cancer cachexia have led to only a small number of related clinical studies addressed to investigating new efficacious treatment modalities for these patients. This typifies the situation existing in modern research; all around the world, public and private institutions and pharmaceutical companies are clearly more oriented to investigating new chemotherapeutic agents potentially able to counteract tumor growth and prolong survival rather than sponsoring clinical studies aimed at ameliorating the quality of life of terminally ill patients.