Cachexia and the future of cancer care

Many people have known someone with cancer, a disease that exacts an emotional and physical toll on all concerned. Cachexia is a major side effect, a muscle-wasting condition causing muscle atrophy, fatigue and anaemia. But La Trobe researchers are improving the lives of cancer patients: they’ve identified a cause of cachexia.

Cachexia often manifests in cancer's advanced stages and can greatly compromise quality of life. It can make patients too weak to perform daily tasks, so they lose independence and time with their family. When a patient gets cachexia, they can become too weak to continue cancer treatment, one of the reasons why cachexia is responsible for up to one third of cancer deaths.

Up to 80 per cent of cancer patients will get cachexia, and for patients with solid tumours and more aggressive cancers, the likelihood is very high.

As La Trobe's Professor Nick Hoogenraad says, ‘If we can arrest cachexia it will give people extra time and improved quality of life. It will make them stronger and allow for therapy to continue. This is a very significant development.’

The magnitude of the discovery

Dr Amelia Johnston is a Research Fellow at La Trobe’s Institute for Molecular Science (LIMS). La Trobe's cachexia breakthrough is the result of almost eight years of research, which she took part in.

‘I don’t tend to throw around the term "world first" – but this is a world-first discovery,’ she says.

The research team made the discovery by chance. They were researching the impact of a particular molecule called Fn14. This molecule is not present in healthy tissue, but the body switches it on when needed, for example, to help heal a wound. But when Fn14 is switched on in cancer cells, instead of helping, it makes it worse.

The discovery was very exciting but a little nerve-wracking. It was totally out there.

For reasons not yet completely understood, the Fn14 molecule causes cachexia.

The team found that if they could block Fn14 from being switching on in cancer cells, they could prevent cachexia's onset.

According to Dr Johnston, ‘We knew a molecule was involved in tumours so we wanted to create an anti-tumour therapy. That was a chance discover, something that had never been described previously or even suggested by anyone. It was very exciting but a little bit nerve wracking because it was totally out there.’

Making a difference

This discovery means a patient will be stronger for a longer time. It will improve quality of life, and could extend and save lives. This means a lot to Dr Johnson, who became involved in this research to make a difference.

I get excited when I consider the big picture – what the discovery might look like in 10 or 15 years.

‘While in the grand scheme of things, making that difference is usually small,’ she explains, ‘you’re adding a piece to the puzzle. It’s exciting to come across something unique and significant – something never discovered before.’

The next steps are to take this discovery, develop it and find a way to treat the disease. That's an exciting prospect.

‘I do get excited when I consider the big picture,' Dr Johnston says. 'What it might look like in 10 or 15 years’ time if it’s successful in the clinic.’

Paving the way to human trials

La Trobe University has entered into a partnership with the Olivia Newton John Cancer Research Institute at Austin Health. Together, they're taking this research into human trials in oncology wards.

Dr Johnston says more research is needed to figure out the details so clinical trials can begin. The research team needs to investigate all possible ramifications and outcomes once the cachexia molecule is switched off.

‘There’s a large research component that’s now a big priority,’ she says. ‘I need to do the best I can to make sure it’s going to be in the clinic, to make sure I can really drive that and save lives.'

It won't happen straight away, though, because there's a long regulatory process that needs to happen first. 'But we hope to be in trials in two to three years,' she says. 'We want to show it’s safe as quickly as we can.’

For Dr Johnston, the impact of this work is monumental.

‘Contributing to a body of research and knowledge is exciting enough, but to think that we’re now on a path to developing a therapy – that’s an indescribable feeling.’

Professor Nicholas Hoogenraad is Emeritus Professor AO in the School of Molecular Sciences, La Trobe Institute for Molecular Science.
Dr Amelia Johnston is a Research Fellow in the School of Molecular Sciences.

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