Effects of Nordic Walking Combined with High-Protein Intake and Time-Restricted Eating on Muscle-Related Outcomes in Postmenopausal Women: A Three-Arm Randomized Controlled Trial.

Patients with cancer frequently experience anorexia, malnutrition, and cachexia which represent a continuum of interrelated metabolic and nutritional disorders arising from a complex interplay among the malignancy itself, anticancer treatments, and cancer-related metabolic dysregulation [–]. These conditions are associated with increased morbidity and mortality, reduced efficacy of anticancer treatments [–] and survival [–], higher risks of post-operative complications [], treatment-related toxicity [, ], and infections [], as well as longer hospital stays and higher costs [, , ]. They also substantially impair quality of life (QoL) [–]. Despite this considerable clinical burden, effective pharmacological options for cancer-related anorexia, malnutrition, and cachexia remain limited, and no drug has been formally approved specifically for these indications. Recently, however, clinical practice guidelines have begun to consider potential pharmacological approaches. The 2021 ESMO clinical practice guidelines and the 2023 ASCO guidelines update conditionally recommend low-dose olanzapine for management of cancer cachexia [, ]. The inclusion of olanzapine in these guidelines reflects a drug-repurposing rationale, as olanzapine is well known to increase appetite and cause weight gain in patients treated for psychiatric disorders [, ]. Important uncertainties nevertheless remain regarding its role in oncology. Although current recommendations focus on low-dose olanzapine, the magnitude of its orexigenic effect, its potential impact across the spectrum of anorexia, malnutrition and cachexia, and the optimal dose, duration and patient selection have not been clearly established. Moreover, the available evidence is fragmented and has not been comprehensively synthesized.