Table. Management of cancer cachexia based on Fearon et al. (26).

	Pre-cachexia	Cachexia	Refractory cachexia
Definition	– Weight loss ≤ 5 % – Metabolic changes	– Weight loss >5% or – BMI <20 + weight loss >2% Often associated with reduced food intake/systemic inflammation	– All symptoms of cachexia – Progressive cancer that does not respond to anticancer therapy – Poor performance status – Life expectancy <3 months
Measures	– Monitoring – Preventive interventions (nutritional advice, exercise options)	Cause-specific, multimodal management with: – N utritional advice and therapy – Oral/parenteral nutrition (25–30 kcal/kg BW/day) with protein supplements (1.0–1.5 g/kg BW/day) – Exercise therapy (to increase muscle and strength) – Psycho-oncological support	– Symptom management – Psycho-oncological support – Establish a set of common goals with respect to nutritional advice for patients and family

BMI, body-mass index; BW, body weight