# Definition and classification of cancer cachexia: an international consensus

Source: https://onco.cc/key-papers/paper-fearon-lancet-oncol/  
OnCo record `paper-fearon-lancet-oncol` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Paper cited by one term page, one bottleneck page and eleven idea pages, indexed on Europe PMC as PubMed record 21296615 and published in The Lancet Oncology; the citing pages link this DOI, which is how the record was matched.

## Summary

To develop a framework for the definition and classification of cancer cachexia a panel of experts participated in a formal consensus process, including focus groups and two Delphi rounds. Cancer cachexia was defined as a multifactorial syndrome defined by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment. Its pathophysiology is characterised by a negative protein and energy balance driven by a variable combination of reduced food intake and abnormal metabolism. The agreed diagnostic criterion for cachexia was weight loss greater than 5%, or weight loss greater than 2% in individuals already showing depletion according to current bodyweight and height (body-mass index [BMI] <20 kg/m(2)) or skeletal muscle mass (sarcopenia). An agreement was made that the cachexia syndrome can develop progressively through various stages--precachexia to cachexia to refractory cachexia. Severity can be classified according to degree of depletion of energy stores and body protein (BMI) in combination with degree of ongoing weight loss. Assessment for classification and clinical management should include the following domains: anorexia or reduced food intake, catabolic drive, muscle mass and strength, functional and psychosocial impairment. Consensus exists on a framework for the definition and classification of cancer cachexia. After validation, this should aid clinical trial design, development of practice guidelines, and, eventually, routine clinical management.

Indexed on Europe PMC as PubMed record 21296615 (DOI 10.1016/s1470-2045(10)70218-7). Matched by DOI alone: one term page, one bottleneck page and eleven idea pages cite this DOI among their external links (the pages are listed under Related), and this page was written so that the citation resolves inside OnCo. No figure has been checked by an editor.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: europepmc-ingest
- Journal: The Lancet Oncology
- Year: 2011
- DOI: 10.1016/s1470-2045(10)70218-7
- Authors: Fearon K, Strasser F, Anker SD, et al.
- What it means: One term page, one bottleneck page and eleven idea pages on OnCo cite this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing pages listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
- Caveats: Matched to the citing OnCo records by DOI alone; the summary reproduces the Europe PMC abstract and no figure has been verified against the full paper.

## Sources

- Lancet Oncol 2011: https://doi.org/10.1016/s1470-2045(10)70218-7
- PubMed: https://pubmed.ncbi.nlm.nih.gov/21296615/
- Europe PMC: https://europepmc.org/article/MED/21296615

## Connected records

- terms: [Cancer cachexia](https://onco.cc/terms/cachexia/)
- bottlenecks: [Cachexia, toxicity and the limits of the patient](https://onco.cc/bottlenecks/b-cachexia-supportive/)
- ideas: [A cheap old tablet to restore appetite](https://onco.cc/ideas/idea-bio2-low-dose-olanzapine-appetite/), [A dietitian in every gastrointestinal and head and neck tumour board](https://onco.cc/ideas/idea-nl-dietitian-in-every-mdt/), [Catch wasting early with a smart scale and a step counter](https://onco.cc/ideas/idea-bio2-remote-weight-step-monitoring/), [Dose chemotherapy by muscle mass, not body surface area](https://onco.cc/ideas/idea-bio2-lean-mass-dosing/), [Four weeks of training and nutrition before major cancer surgery, as standard](https://onco.cc/ideas/idea-bio2-prehabilitation-standard/), [Get the one approved appetite drug licensed beyond a single country](https://onco.cc/ideas/idea-bio2-anamorelin-access/), [Pay for supervised exercise the way we pay for drugs](https://onco.cc/ideas/idea-bio2-exercise-reimbursement/), [Read muscle loss automatically from scans patients already have](https://onco.cc/ideas/idea-bio2-ai-sarcopenia-from-ct/), [Test protein and resistance training during immunotherapy](https://onco.cc/ideas/idea-bio2-protein-plus-training-during-io/), [Treat cachexia as a disease: GDF-15 blockade plus anabolic and nutrition bundles](https://onco.cc/ideas/idea-moon-cachexia-as-treatable-disease/), [Treat wasting like sepsis: a trigger, a bundle, an audit](https://onco.cc/ideas/idea-bio2-cachexia-pathway-code/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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