Treat cachexia as a disease: GDF-15 blockade plus anabolic and nutrition bundles
The wasting that kills many cancer patients has had no effective drug. New antibodies against GDF-15 restored weight in early trials. Combine them with exercise and nutrition and test properly.
Cancer cachexia affects a large share of patients with pancreatic, lung and gastric cancer and contributes directly to death and treatment intolerance. Ponsegromab, an anti-GDF-15 antibody, increased weight and activity in a randomised phase 2 trial; ghrelin agonists (anamorelin) are approved in Japan. The proposal is a programme treating cachexia as an indication in its own right: standardised diagnosis and staging, a phase 3 of GDF-15 blockade with function and survival endpoints, and multimodal bundles combining pharmacotherapy with resistance exercise and nutritional support, embedded early in oncology care rather than at end of life.
- Cachexia, toxicity and the limits of the patient · Patients often die of wasting or cannot tolerate the doses that would work. Treating the patient, not just the tumour, lags far behind.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.