Circulating Activin A is predictive of survival of cancer patients

Introduction and aim We demonstrated that human cancer cachexia is associated with increased circulating concentrations of Activin A. Given the cachectic and anorectic effect of Activin A demonstrated in animal models, our observation suggests that Activin A might play a role in the development of human cancer cachexia. Indeed, circulating Activin A was correlated positively with weight loss and negatively with skeletal muscle density, two well-established prognosis factors in cancer patients. Our goal was to investigate the value of circulating Activin A as a marker of survival in cancer patients. Material and methods Patients with colorectal or lung cancer were recruited at the time of diagnosis or at relapse and had clinical, nutritional (SNAQ score) and functional (ECOG, QLQC30) assessment. Body composition and skeletal muscle density were measured by CT-scan and plasma concentrations of Activin A were determined. Overall survival was estimated during 12 months (–1/ + 2 months) after inclusion. Results Among 152 patients included in the study, survival data was available for 149 patients. Patients with high levels of Activin A (> 665 pg/mL) had lower overall survival (68%) than those with levels in the normal range (84%; P P P P P P P P P Conclusion In cancer patients, a high circulating concentration of Activin A was associated with a shorter overall survival. Significant weight loss, low muscularity and low skeletal muscle density, were also associated with a poor prognosis.