Successful lung cancer management has been hindered by the limited eff
icacy of dietary and pharmacologic interventions to prevent or reverse
cancer-associated weight loss. The addition of total parenteral nutri
tion to chemotherapy in early trials was associated with survival detr
iment. Dietary counseling and enteral supplement use are common strate
gies that, when evaluated in randomized trials, do not improve anthrop
ometrics or clinical outcome in lung cancer. Pharmacologic agents incl
uding corticosteroids, cyproheptadine, growth hormone, hydrazine sulfa
te, dronabinol, and pentoxyphylline also have failed to improve even a
nthropometric parameters in this condition. Megestrol acetate use is a
ssociated with appetite stimulation and non-fluid weight gain but, whe
n evaluated in small cell lung cancer patients receiving defined chemo
therapy, failed to improve global quality of life, and survival and wa
s associated with toxicity. New strategies for nutrition-based interve
ntions in lung cancer cachexia must consider their potential influence
on tumor growth as well as on nutritional status. Recent lung cancer
prognostic analyses have identified gender differences in outcome and
weight loss that suggest potential targets for combined hormonal and n
utrition interventions. Emerging information regarding the influence o
f specific fatty acids on tumor growth and cachexia development have i
dentified additional approaches for future evaluation.