Cancer cachexia kills millions of people worldwide every decade. Attenuating or mitigating this muscle-wasting condition associated with cancer could significantly reduce cancer-related deaths. The drug development pipeline takes 10 – 15 years to complete in the United States. During this period, hundreds of thousands to millions worldwide die of cancer cachexia. Medicines already approved by the United States Food and Drug Administration that cause significant muscle mass gains in healthy individuals could be used “off-label” or “repurposed” in individuals who do not have androgen receptor-responsive cancers. These agents are testosterone and anabolic steroids. In individuals with androgen receptor-responsive tumors, repurposing anabolic agents (e.g., beta-2 adrenergic agonist albuterol), which increases muscle mass through different mechanisms than the androgen receptor, is warranted. New research suggests that phenotyping for the androgen receptor must be conducted individually, even for the same cancer. The utilization of these two types of anabolic agents – those that use the androgen receptor and those that do not – in appropriate clinical trials in cancer cachexia is also warranted.

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