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Ballarò et al. J Cancer Metastasis Treat 2019;5:61 Journal of Cancer
DOI: 10.20517/2394-4722.2019.003 Metastasis and Treatment

Review Open Access

Muscle mitochondria and oxidative metabolism as
targets against cancer cachexia

Riccardo Ballarò , Fabio Penna , Elisabetta Ferraro , Paola Costelli 1,2
1,2
1,2
1,3
1 Department of Clinical and Biological Sciences, Experimental Medicine and Clinical Pathology Unit, University of Torino, Torino
10125, Italy.
2 Interuniversity Institute of Myology, Urbino 61029, Italy.
3 Department of Orthopaedics and Traumatology, Hospital "Maggiore della Carità", University of Piemonte Orientale, Via Ettore
Perrone, 18, Novara 28100, Italy.
Correspondence to: Dr. Paola Costelli, Department of Clinical and Biological Sciences, Experimental Medicine and Clinical
Pathology Unit, University of Torino, Corso Raffaello 30, Torino 10125, Italy.

How to cite this article: Ballarò R, Penna F, Ferraro E, Costelli P. Muscle mitochondria and oxidative metabolism as targets against
cancer cachexia. J Cancer Metastasis Treat 2019;5:61. http://dx.doi.org/10.20517/2394-4722.2019.003

Received: 10 Apr 2019 First Decision: 17 May 2019 Revised: 31 May 2019 Accepted: 18 Jun 2019 Published: 14 Aug 2019
Science Editor: Ciro Isidoro Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Cancer cachexia is a debilitating syndrome mainly characterized by muscle and fat wasting, leading to the
progressive loss of body weight and complicating the management of cancer patient. In particular, the loss of muscle
weight is a negative prognostic factor, being associated with chemotherapy toxicity and reduced survival. Increased
inflammation and protein dysmetabolism are some of the impairments that lead to muscle wasting in cancer
patients. Together with these alterations, tumor growth and chemotherapy administration may affect mitochondrial
function, impinging on the muscle energy metabolism. Indeed, therapeutic approaches poised to correct both
hypercatabolism and mitochondrial alterations could be effective in preventing cancer-induced muscle wasting.
Among the non-pharmacological approaches, exercise training is one of the best modulator of muscle physiology
able to impinge on both protein and energy metabolism. However, the wasting phenotype that characterizes cancer
patients could be not compatible with physical training, prompting the development of different strategies to
improve muscle metabolism. The aim of this mini-review is to discuss both the beneficial effects and the limitations
of exercise training in cancer cachexia and the adoption of drugs able to modulate exercise-induced pathways.

Keywords: Muscle wasting, exercise, PGC-1α, trimetazidine, erythropoietin

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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