Journal of Cachexia, Sarcopenia and Muscle
© Springer-Verlag 2012

Letter to the Editor

Evidence for an effect of ACE inhibitors on cancer cachexia

Nancy Schanze1, 2 and Jochen Springer1, 2, 3 Contact Information

(1)  Applied Cachexia Research, Department of Cardiology, Charité Medical School, Berlin, Germany
(2)  Center for Cardiovascular Research, Charite Medical School, Hessische Str. 3-4, 10115 Berlin, Germany
(3)  Norwich Medical School, University of East Anglia, Norwich, UK

Contact Information Jochen Springer

Received: 10 May 2012  Accepted: 13 May 2012  Published online: 25 May 2012

Without Abstract

Dear Editor,

In a recent review article by Trobec et al., it was stated that there are no data on the effects of ACE inhibition in the field of cancer cachexia, even though there is some evidence for a beneficial effect on muscle mass in chronic heart failure, i.e. cardiac cachexia [1]. While it is true that there are no PubMed-listed clinical studies, Ark Therapeutics has completed a phase III clinical trial on the use of imidapril in non-small cell lung cancer (NSCLC), colorectal cancer and pancreatic cancer which showed significant reduction in the rate of weight loss in both NSCLC and colorectal cancer but not in pancreatic cancer. However, when analyzed together, the significance on weight loss reduction was lost and hence the trial missed its primary endpoint [2]. These results prompted a second phase III trial in August 2008, which was focused on NSCLC [3]. However, due to a commercial refocusing, Ark Therapeutics is no longer pursuing this study. Furthermore, there is evidence from pre-clinical models that ACE inhibition can indeed reduce wasting of muscle mass in cancer cachexia [4]. Taken together, there are some data—albeit limited—on the usefulness of ACE inhibition in cancer cachexia.

Acknowledgments  The author of this manuscript certifies that he complied with the ethical guidelines for authorship and publishing in the Journal of Cachexia, Sarcopenia and Muscle [5].
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1. Trobec K, von Haehling S, Anker SD, Lainscak M. Growth hormone, insulin-like growth factor 1, and insulin signaling-a pharmacological target in body wasting and cachexia. J Cachexia Sarcopenia Muscle. 2011;2:191–200. Epub 2011 Oct PubMed PMID: 22207907; PubMed Central PMCID: PMC3222822.
PubMed SpringerLink
4. Sanders PM, Russell ST, Tisdale MJ. Angiotensin II directly induces muscle protein catabolism through the ubiquitin-proteasome proteolytic pathway and may play a role in cancer cachexia. Br J Cancer. 2005;93:425–34.
PubMed CrossRef ChemPort
5. von Haehling S, Morley JE, Coats AJ, Anker SD. Ethical guidelines for authorship and publishing in the Journal of Cachexia, Sarcopenia and Muscle. J Cachexia Sarcopenia Muscle. 2010;1:7–8.