Appetite Loss in Metastatic Cancer: Insights from Clinical and Inflammatory Markers Observed Longitudinally
Ragnhild Habberstad, Ola Magne Vagnildhaug, Trude Rakel Balstad, Øyvind Salvesen, Erik Torbjørn Løhre, Asta Bye, Olav Dajani, Nina Aass, Stein Kaasa, Pål Klepstad, Tora S. SolheimBackground: Inflammation is suggested to play a central role in cancer-related appetite loss, yet the available evidence remains limited. Methods: This study analyzed data from a prospective, longitudinal, multicenter study of patients with metastatic cancer followed for one year. The longitudinal associations between appetite loss and both clinical characteristics and inflammatory markers were examined. Logistic generalized equation model (GEE) was used. Results: Among 526 patients, 299 (57%) experienced appetite loss at baseline. During longitudinal observation appetite loss was associated with older age (OR 1.19, CI 1.01–1.39 as per 10-year years increase), poorer performance status (OR 0.85, CI 0.77–0.94), recent weight loss (OR 2.74, CI 2.11–3.56), and symptoms including constipation, nausea, fatigue, and lower emotional functioning. Corticosteroid use was associated with lower risk of appetite loss (OR 0.69, CI 0.53–0.90). Several inflammatory markers were also associated with appetite loss, including IL-8, IP-10, IL-6, CRP, eotaxin, albumin. Conclusions: Appetite loss in metastatic cancer is linked to clinical factors, symptom burden, and inflammatory markers. Optimizing symptom management and targeting inflammation might have a positive impact.