PROGESTERONE DERIVATIVES IN CANCER CACHEX IA

Cachexia frequently occurs in cancer patients. Indeed, this syndrome a ffects about 50% of hospitalized patients. This clinical entity may be described by different characteristics: appetite and weight loss, sev eral metabolic abnormalities, possible influence of cytokines, poor pr ognosis. During the last decade, several papers have shown the benefic ial activity of medroxyprogesterone acetate (MPA) and megestrol acetat e (MA) in cancer cachexia. Seven randomized trials emphasized their ac tivity on patients weight and appetite. Megestrol acetate doses in tho se trials are different: from 160 mg/24 h to 1600 mg/24 h; this drug i s similar to MPA in terms of clinical and pharmacological properties. Iatrogenic toxicity due to MA and MPA is mild, but numerous questions still subsist: optimal date of introduction during the course of the d isease, posology, treatment duration and its impact on quality of life of cancer patients.