Landscape of Clinical Trials in Cancer Cachexia: Assessment of Trends From 1995-2024

Cancer cachexia (CC), a multifactorial syndrome characterized by unintentional weight loss, is a frequent complication of cancer that impacts patients’ quality of life and survival. In this retrospective review, we evaluated the landscape of clinical trials (CTx) registered on ClinicalTrials.gov for the consideration of potential factors contributing to human heterogeneity in their design and analyses. Among CTx registered from 1995-2024, we observed a trend toward equality in including female participants, but lack of reporting of sex as a biological variable. Limited demographic diversity was observed with ∼93% White population participation. There was a substantial divergence in the diagnostic criteria and a wide range of tools employed to measure CC. Lastly, few studies considered cancer type and stage as clinical variables. Overall, a substantial gap remains in our knowledge of CC in non-white and female populations. Ultimately, these underreported data across CC CTx complicate the comparison and interpretation of CTx results, both within understudied populations and in specific cancer types. The current evolution of knowledge and new methodologies used for CC assessment reinforce the need for a constant revision of the CC consensus definition and diagnosis criteria to align with current advances in our understanding of human heterogeneity in CC.