{"doi":"10.1002/jcsm.12910","title":"Addressing unmet needs for people with cancer cachexia: recommendations from a multistakeholder workshop","abstract":"In October 2020, LUNGevity Foundation hosted 75 participants for a comprehensive Unmet Needs Workshop focused on addressing the needs of patients with cancer cachexia and their caregivers. A unique aspect of this workshop was that it centred on the patient perspective and yielded active involvement of patients, caregivers, patient advocates, clinicians, scientists, investigators, industry representatives, and regulators. Participants met virtually to discuss the state of the science, identify clinical and research gaps, and develop concrete action plans. Three needs emerged: (i) need to expand education about cancer cachexia among patients, caregivers, and clinicians; (ii) need to increase evidence, resources, and insurance coverage for medical nutritional and physical therapy for patients with cancer cachexia; and (iii) need to refine preclinical research, definition, diagnostic criteria, biomarkers, clinical trial inclusion criteria, and clinically meaningful endpoints to develop and implement effective therapies. This paper summarizes the diverse perspectives presented during the workshop, describes the key themes, and outlines recommendations made by this multistakeholder group to effectively meet the needs of people with cancer cachexia and their caregivers. Patients with cancer often experience progressive weight loss.1 Indeed, unintentional weight loss often precipitates the first visit and subsequent diagnosis of cancer. Such weight loss, or cachexia, is particularly common in patients with cancers of the head and neck, lung, and gastrointestinal tract and contributes greatly to cancer morbidity and mortality, more so among the elderly.2, 3 Cachexia reduces appetite, social–emotional interactions, functional capacity, and quality of life, and up to a third of cancer deaths have been attributed to cachexia.4-6 Despite its impact on cancer, there are no widely approved, effective therapies for cancer cachexia, and perhaps consequentially, there is typically minimal discussion of cachexia symptoms or interventions between patients and clinicians, including physicians, physician assistants, nurse practitioners, nurses, dieticians, and physical and behavioural therapists. Furthermore, available supportive care varies greatly by clinician, institution, and payer, leading to disparate outcomes for patients. Filling these gaps in cachexia care would reduce patient and caregiver distress and improve cancer outcomes. Diagnostic criteria for cachexia vary somewhat, but a widely accepted consensus defines cachexia as >5% unintentional weight loss over 6 months with muscle mass loss, with or without fat loss, that leads to progressive functional impairment.1 Staging of cachexia is intended to represent its severity, understand who might benefit from targeted interventions, and guide treatment decisions for those at the end of life. While there are various approaches to the classification of patients, often cachexia is classified into three stages: pre-cachexia (weight loss of <5% with anorexia and metabolic changes), cachexia [weight loss of >5% or body mass index (BMI) < 20 kg/m2 with 2% weight loss, or sarcopenia with >2% weight loss, including poor oral intake and is often associated with systematic inflammation], and refractory cachexia (low performance status and life expectancy of <3 months). The latter is characterized by end-stage cancer and poor performance status and is typically thought of as unresponsive to cachexia-directed treatment.1, 5, 7 Weight loss and reduction in BMI are associated with shorter median survival times in patients with cancer, which is further exaggerated with more severe weight loss and lower BMI.8 Patients with cancer and combined weight and muscle loss experience the poorest survival outcomes irrespective of BMI,9 in part due to the necessity of dose reductions and modifications. Conversely, weight stabilization has been tied to improved outcomes in several studies.10, 11 The pathophysiology of ","journal":"Journal of Cachexia Sarcopenia and Muscle","year":2022,"id":247156,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":34,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9515,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":254920,"name":"Richard F. Dunne","orcid":"0000-0001-6608-660X","position":1,"is_corresponding":false},{"id":402911,"name":"Kristen Santiago","orcid":"0000-0002-5813-2669","position":2,"is_corresponding":false},{"id":884564,"name":"Lisa Martin","orcid":"0000-0003-4518-7246","position":3,"is_corresponding":false},{"id":619146,"name":"Morris J. Birnbaum","orcid":"0000-0001-9972-8680","position":4,"is_corresponding":false},{"id":679866,"name":"Jeffrey Crawford","orcid":"0000-0002-1274-1354","position":5,"is_corresponding":false},{"id":226205,"name":"Andrew Hendifar","orcid":"0000-0002-2079-9177","position":6,"is_corresponding":false},{"id":885191,"name":"Martin Kochanczyk","orcid":null,"position":7,"is_corresponding":false},{"id":885192,"name":"Cassadie Moravek","orcid":null,"position":8,"is_corresponding":false},{"id":885193,"name":"Doris Piccinin","orcid":null,"position":9,"is_corresponding":false},{"id":885194,"name":"Vincent J. Picozzi","orcid":null,"position":10,"is_corresponding":false},{"id":260768,"name":"Eric Roeland","orcid":"0000-0002-3674-3573","position":11,"is_corresponding":false},{"id":884565,"name":"Wendy Selig","orcid":"0000-0002-9252-7170","position":12,"is_corresponding":false},{"id":339657,"name":"Teresa A. Zimmers","orcid":"0000-0001-7872-0540","position":13,"is_corresponding":false},{"id":363495,"name":"José M. Garcia","orcid":"0000-0002-4245-1753","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T00:23:53.369530Z","pmid":"35218313","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}