Cancer-Associated Muscle Wasting-Candidate Mechanisms and Molecular Pathways

Excessive muscle loss is commonly observed in cancer patients and its association with poor prognosis has been well-established. Cancer-associated sarcopenia differs from age-related wasting in that it is not responsive to nutritional intervention and exercise. This is related to its unique pathogenesis, a result of diverse and interconnected mechanisms including inflammation, disordered metabolism, proteolysis and autophagy. There is a growing body of evidence that suggests that the tumor is the driver of muscle wasting by its elaboration of mediators that influence each of these pro-sarcopenic pathways. In this review, evidence for these tumor-derived factors and putative mechanisms for inducing muscle wasting will be reviewed. Potential targets for future research and therapeutic interventions will also be reviewed.

C-reactive protein at the interface between innate immunity and inflammation

C-reactive protein (CRP), the prototypic acute-phase protein, increases rapidly in response to infection and inflammation. Although CRP was thought to be a passive, nonspecific marker of inflammation, recent studies indicate that CRP plays a key role in the innate immune system by recognizing pathogens and altered self determinants. Activation of complement and interaction with Fcgamma receptors by CRP provides a link between the innate and adaptive immune systems. Recent evidence suggests that CRP is a marker of atherosclerotic disease and may play a role in its induction. However, CRP has an anti-inflammatory role in autoimmune diseases, such as systemic lupus erythematosus. In this article, we review the biological mechanisms by which CRP exerts its effects on the immune system and discuss its role in infection, cardiovascular disease, malignancy and systemic lupus erythematosus.

Update in systemic therapy of prostate cancer: improvement in quality and duration of life

Overall survival benefit with a docetaxel and prednisone regimen in metastatic androgen-independent prostate cancer marked a major advance in the management of prostate cancer. Immunotherapy, antiangiogenic therapies and targeted agents are areas of active research interest. Simultaneous progress in palliative and supportive care has enabled us to improve the quality of life of advanced prostate cancer patients. Multiple predictors of outcome have been reported, and systemic therapy is being actively explored in localized disease. This review attempts to summarize the risk profiling strategy in prostate cancer and the existing therapies in high-risk prostate cancer, including some of the novel agents under investigation.