Antoun S, Birdsell L, Sawyer MB et al.
Institut Gustave Roussy, Villejuif, France.
J Clin Oncol 2010;28:1054–60.
Editor’s note: Advanced malignant disease is associated with weight loss involving both fat and lean body mass, particularly skeletal muscle. Significant skeletal muscle wasting (sarcopenia) is an important prognostic factor in patients with solid tumors and is a predictor of severe treatment toxicity in some cancers. The impact of treatment on cancer-associated wasting is not well characterized. The current authors sought to determine the effects of sorafenib on skeletal muscle wasting in patients with advanced renal cell carcinoma (RCC). Sorafenib is a multikinase inhibitor that has antiangiogenic action via vascular endothelial growth factor receptors. It causes downstream suppression of phosphoinositide 3-kinase, protein kinase B, and mammalian target of rapamycin, which are key mediators in activating protein synthesis. The authors therefore hypothesized that sorafenib treatment would induce skeletal muscle loss.