Preview

Siberian journal of oncology

Advanced search

Biochemical markers of skeletal muscle metabolism and their clinical signifance in oncology: a literature review

https://doi.org/10.21294/1814-4861-2026-25-1-146-154

Abstract

Objective: to analyze current approaches to the assessment of biochemical markers of skeletal muscle metabolism, to identify promising research directions in this feld, and to outline potential therapeutic strategies.
Material and Methods. The literature search for the preparation of the review was conducted using the Web of Science, Scopus, MEDLINE, Cochrane Library, RSCI, and PubMed databases. A total of 146 sources were analyzed, of which 47 scientifc publications were selected. The review includes studies published between 2010 and 2025.
Results. Sarcopenia in cancer patients involves four key proteolytic cascades: the ubiquitin– proteasome pathway, autophagic pathway, calpain-dependent pathway, and caspase-dependent pathway. Particular attention was given to the prognostic role of biochemical markers, including muscle-specifc E3 ligases (MuRF1, Atrogin-1), infammatory cytokines, and cystatin C. A high prognostic value of the creatinineto-cystatin C ratio was demonstrated for assessing the risk of anticancer therapy toxicity and mortality. Promising molecular targets, such as AMPK, IGF-1/AKT/mTOR, and the NF-κB, were identifed for targeted therapy.
Conclusion. Sarcopenia in cancer arises from complex and molecular mechanisms, including both protein degradation and impaired muscle tissue regeneration. The use of biochemical markers and targeted interventions opens up prospects for precise, personalized medicine, enabling earlier diagnosis, accurate prognosis, and tailored treatments. Further clinical studies are required to validate biomarkers and evaluate the effectiveness of novel therapeutic strategies aimed at preventing muscle atrophy in cancer patients.

About the Authors

D. A. Bereznikova
Kursk State Medical University, Ministry of Health of Russia; G.E. Ostroverkhov Kursk Cancer Research and Clinical Center
Russian Federation

Darya A. Bereznikova, Postgraduate, Department of Oncology; Oncologist, Outpatient Cancer Care Center 

3, Karl Marx St., Kursk, 305004;
1, Eliseeva St., Kursk, 305524



U. S. Stanoevich
Kursk State Medical University, Ministry of Health of Russia; G.E. Ostroverkhov Kursk Cancer Research and Clinical Center
Russian Federation

Uglesha S. Stanoevich, MD, DSc, Professor, Head of the Department of Oncology; Head Physician 

3, Karl Marx St., Kursk, 305004;
1, Eliseeva St., Kursk, 305524



References

1. Lee K., Park S.J., Kim J., Hong S.H., Kim I.H., Lee J., Lee M.A., Shin K., Mun H.S. Skeletal Muscle Density as a Predictor of Prognosis and Physical Reserve in Patients with Cancer of Unknown Primary. J Clin Med. 2025; 14(9): 2947. doi: 10.3390/jcm14092947.

2. Jurdana M., Cemazar M. Sarcopenic obesity in cancer. Radiol Oncol. 2024; 58(1): 1–8. doi: 10.2478/raon-2024-0011.

3. Lyadov V.K., Dikova T.S., Zatsepina A.Y., Ivashchenko D.V. Sarcopenia, sarcopenic obesity, myosteatosis as factors of poor prognosis in gastrointestinal tract tumors: sistematic review. Journal of Modern Oncology. 2022; 24(2): 234–41. (in Russian). doi: 10.26442/18151434.2022.2.201710. EDN: NLGDPG.

4. Agca S., Kir S. The role of interleukin-6 family cytokines in cancer cachexia. FEBS Journal. 2024; 291(18): 4009–23. doi: 10.1111/febs.17224.

5. Gagnon B., Murphy J., Simonyan D., Penafuerte C.A., Sirois J., Chasen M., Tremblay M.L. Cancer anorexia-cachexia syndrome is characterized by more than one infammatory pathway. J Cachexia Sarcopenia Muscle. 2024; 15(3): 1041–53. doi: 10.1002/jcsm.13430.

6. Paval D.R., Patton R., McDonald J., Skipworth R.J.E., Gallagher I.J., Laird B.J., Caledonian Cachexia Collaborative. A systematic review examining the relationship between cytokines and cachexia in incurable cancer. J Cachexia Sarcopenia Muscle. 2022; 13(2): 824–38. doi: 10.1002/jcsm.12912.

7. Nishikawa H., Goto M., Fukunishi S., Asai A., Nishiguchi S., Higuchi K. Cancer cachexia: its mechanism and clinical signifcance. Int J Mol Sci. 2021; 22(16): 8491. doi: 10.3390/ijms22168491.

8. Zeng X., Zhao L., Chen Z., Kong L., Chen S. Calpain inhibitors inhibit mitochondrial calpain activity to ameliorate apoptosis of cocultured myoblast. Chin J Physiol. 2022; 65(5): 226–32. doi: 10.4103/0304-4920.359797.

9. Vainshtein A., Sandri M. Signaling pathways that control muscle mass. Int J Mol Sci. 2020; 21(13): 4759. doi: 10.3390/ijms21134759.

10. Baczek J., Silkiewicz M., Wojszel Z.B. Myostatin as a Biomarker of Muscle Wasting and other Pathologies-State of the Art and Knowledge Gaps. Nutrients. 2020; 12(8): 2401. doi: 10.3390/nu12082401.

11. Adamova I.G., Taraki B.M., Ibragimova G.M., Fedorov I.G., Manuylova O.O., Pshennikova I.G., Il’chenko L.Y., Nikitin I.G. Phenotypic features of sarcopenia in fatty liver disease. Effective Pharmacotherapy 2024; 20(18): 86–92. (in Russian). doi: 10.33978/2307-3586-2024-20-18-86-92. EDN: EBRXGD.

12. Vanhorebeek I., Casaer M.P., Gunst J. Nutrition and autophagy defciency in critical illness. Curr Opin Crit Care. 2023; 29(4): 306–14. doi: 10.1097/MCC.0000000000001056.

13. Sebastián D., Beltrà M., Irazoki A., Sala D., Aparicio P., Aris C., Alibakhshi E., Rubio-Valera M., Palacín M., Castellanos J., Lores L., Zorzano A. TP53INP2-dependent activation of muscle autophagy ameliorates sarcopenia and promotes healthy aging. Autophagy. 2024; 20(8): 1815–24. doi: 10.1080/15548627.2024.2333717.

14. Vanhorebeek I., Gunst J., Derde S., Derese I., Boussemaere M., Güiza F., Martinet W., Timmermans J.P., D’Hoore A., Wouters P.J, van den Berghe G. Insufcient activation of autophagy allows cellular damage to accumulate in critically ill patients. J Clin Endocrinol Metab. 2011; 96(4): 633–45. doi: 10.1210/jc.2010-2563.

15. Feng Y., He D., Yao Z., Klionsky D.J. The machinery of macroautophagy. Cell Research. 2014; 24(1): 24–41. doi: 10.1038/cr.2013.168.

16. Dooley H.C., Razi M., Polson H.E.J., Girardin S.E., Wilson M.I., Tooze S.A. WIPI2 links LC3 conjugation with PI3P, autophagosome formation, and pathogen clearance by recruiting Atg12-5-16L1. Mol Cell. 2014; 55(2): 238–52. doi: 10.1016/j.molcel.2014.05.021.

17. Jung C.Y., Kim H.W., Han S.H., Yoo T.H., Kang S.W., Park J.T. Creatinine-cystatin C ratio and mortality in cancer patients: a retrospective cohort study. J Cachexia Sarcopenia Muscle. 2022; 13(4): 2064–72. doi: 10.1002/jcsm.13006.

18. Gao S., Xie H., Wei L., Liu M., Liang Y., Wang Q., Tang S., Gan J. Serum creatinine/cystatin C ratio as a prognostic indicator for patients with colorectal cancer. Front Oncol. 2023; 13: 1155520. doi: 10.3389/fonc.2023.1155520.

19. Sun J., Yang H., Cai W., Zheng J., Shen N., Yang X., Pan B., Zhang W., Chen X., Shen X. Serum creatinine/cystatin C ratio as a surrogate marker for sarcopenia in patients with gastric cancer. BMC Gastroenterol. 2022; 22(1): 26. doi: 10.1186/s12876-022-02093-4.

20. Cuciureanu D., Filip P.V., Pop C.S., Diaconu S.L. A short history of sarcopenia and frailty and their impact on advanced chronic liver disease. J Med Life. 2024; 17(7): 660–64. doi: 10.25122/jml-2024-0304.

21. Cruz-Jentoft A.J., Baeyens J.P., Bauer J.M., Boirie Y., Cederholm T., Landi F., Martin F.C., Michel J.P., Rolland Y., Schneider S.M., Topinková E., Vandewoude M., Zamboni M., European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on defnition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010; 39(4): 412–23. doi: 10.1093/ageing/afq034.

22. Najm A., Niculescu A.G., Grumezescu A.M., Beuran M. Emerging Therapeutic Strategies in Sarcopenia: An Updated Review on Pathogenesis and Treatment Advances. Int J Mol Sci. 2024; 25(8): 4300. doi: 10.3390/ijms25084300.

23. Cederholm T., Barazzoni R., Austin P., Ballmer P., Biolo G., Bischoff S.C., Compher C., Correia I., Higashiguchi T., Holst M., Jensen G.L., Malone A., Muscaritoli M., Nyulasi I., Pirlich M., Rothenberg E., Schindler K., Schneider S.M., de van der Schueren M.A., Sieber C., Valentini L., Yu J.C., Van Gossum A., Singer P. ESPEN guidelines on defnitions and terminology of clinical nutrition. Clin Nutr. 2017; 36(1): 49–64. doi: 10.1016/j.clnu.2016.09.004.

24. Cederholm T., Jensen G.L., Correia M.I.T.D., Gonzalez M.C., Fukushima R., Higashiguchi T., Baptista G., Barazzoni R., Blaauw R., Coats A., Crivelli A., Evans D.C., Gramlich L., Fuchs-Tarlovsky V., Keller H., Llido L., Malone A., Mogensen K.M., Morley J.E., Muscaritoli M., Nyulasi I., Pirlich M., Pisprasert V., de van der Schueren M.A.E., Siltharm S., Singer P., Tappenden K., Velasco N., Waitzberg D., Yamwong P., Yu J., Van Gossum A., Compher C. GLIM Core Leadership Committee; GLIM Working Group. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clin Nutr. 2019; 38(1): 1–9. doi: 10.1016/j.clnu.2018.08.002.

25. Khoroshilov I.E. Cachexia and sarcopenia at oncological patients: Diagnostics and treatment tactics. Clinical Nutrition and Metabolism. 2020; 1(1): 36–46. (in Russian). doi: 10.36425/clinnutrit20650. EDN: DKQKLF.

26. Valenzuela C.A., Ponce C., Zuloaga R., González P., AvendañoHerrera R., Valdés J.A., Molina A. Efects of crowding on the three main proteolytic mechanisms of skeletal muscle in rainbow trout (Oncorhynchus mykiss). BMC Vet Res. 2020; 16(1): 294. doi: 10.1186/s12917-020-02518-w.

27. Jiao J., Demontis F. Skeletal muscle autophagy and its role in sarcopenia and organismal aging. Curr Opin Pharmacol. 2017; 34: 1–6. doi: 10.1016/j.coph.2017.03.009.

28. Lee D.E., Bareja A., Bartlett D.B., White J.P. Autophagy as a therapeutic target to enhance aged muscle regeneration. Cells. 2019; 8(2): 183. doi: 10.3390/cells8020183.

29. Kirkin V. History of the Selective Autophagy Research: How Did It Begin and Where Does It Stand Today? J Mol Biol. 2020; 432(1): 3–27. doi: 10.1016/j.jmb.2019.05.010.

30. Zhang J. Teaching the basics of autophagy and mitophagy to redox biologists – mechanisms and experimental approaches. Redox Biol. 2015; 4: 242–59. doi: 10.1016/j.redox.2015.01.003.

31. Mostowy S. Multiple roles of the cytoskeleton in bacterial autophagy. PLoS Pathog. 2014; 10(11): e1004409. doi: 10.1371/journal.ppat.1004409.

32. Gopal Krishnan P.D., Lee W.X., Goh K.Y., Choy S.M., Turqueza L.R.R., Lim Z.H., Tang H.W. Transcriptional regulation of autophagy in skeletal muscle stem cells. Dis Model Mech. 2025; 18(2): DMM052007. doi: 10.1242/dmm.052007.

33. Sirago G., Picca A., Calvani R., Coelho-Júnior H.J., Marzetti E. Mammalian Target of Rapamycin (mTOR) Signaling at the Crossroad of Muscle Fiber Fate in Sarcopenia. Int J Mol Sci. 2022; 23(22): 13823. doi: 10.3390/ijms232213823.

34. Kuno A., Hosoda R., Sebori R., Hayashi T., Sakuragi H., Tanabe M., Horio Y. Resveratrol Ameliorates Mitophagy Disturbance and Improves Cardiac Pathophysiology of Dystrophin-defcient mdx Mice. Sci Rep. 2018; 8(1): 15555. doi: 10.1038/s41598-018-33930-w.

35. Mariean C.R., Tiucă O.M., Mariean A., Cotoi O.S. Cancer Cachexia: New Insights and Future Directions. Cancers (Basel). 2023; 15(23): 5590. doi: 10.3390/cancers15235590.

36. Madeddu C., Sanna E., Gramignano G., Tanca L., Cherchi M.C., Mola B., Petrillo M., Macciò A. Correlation of Leptin, Proinfammatory Cytokines and Oxidative Stress with Tumor Size and Disease Stage of Endometrioid (Type I) Endometrial Cancer and Review of the Underlying Mechanisms. Cancers (Basel). 2022; 14(2): 268. doi: 10.3390/cancers14020268.

37. Vita E., Stefani A., Piro G., Mastrantoni L., Cintoni M., Cicchetti G., Sparagna I., Monaca F., Horn G., Russo J., Barone D., Di Salvatore M., Trisolini R., Lococo F., Mazzarella C., Cancellieri A., Carbone C., Larici A.R., Mele M.C., Pilotto S., Milella M., Tortora G., Bria E. Leptin-mediated meta-infammation may provide survival beneft in patients receiving maintenance immunotherapy for extensive-stage small cell lung cancer (ES-SCLC). Cancer Immunol Immunother. 2023; 72(11): 3803–12. doi: 10.1007/s00262-023-03533-0.

38. Ma Y., Yan Q., Wang P., Guo W., Yu L. Therapeutic potential of ghrelin/GOAT/GHSR system in gastrointestinal disorders. Front Nutr. 2024; 11: 1422431. doi: 10.3389/fnut.2024.1422431.

39. Fang R., Yan L., Liao Z. Abnormal lipid metabolism in cancerassociated cachexia and potential therapy strategy. Front Oncol. 2023; 13: 1123567. doi: 10.3389/fonc.2023.1123567.

40. Wang Y., Dong Z., An Z., Jin W. Cancer cachexia: Focus on cachexia factors and inter-organ communication. Chin Med J (Engl). 2024; 137(1): 44–62. doi: 10.1097/CM9.0000000000002846.

41. Soria Rivas A., Escobar Álvarez Y., Blasco Cordellat A., Majem Tarruella M., Molina Mata K., Motilla de la Cámara M., Del Mar Muñoz Sánchez M., Zafra Poves M., Beato Zambrano C., Cabezón Gutierrez L. SEOM clinical guidelines for cancer anorexia-cachexia syndrome (2023). Clin Transl Oncol. 2024; 26(11): 2866–76. doi: 10.1007/s12094-024-03502-8.

42. Metwally E., Al-Abbadi H.A., Hussain T., Murtaza G., Abdellatif A.M., Ahmed M.F. Calpain signaling: from biology to therapeutic opportunities in neurodegenerative disorders. Front Vet Sci. 2023; 10: 1235163. doi: 10.3389/fvets.2023.1235163.

43. Smith I.J., Dodd S.L. Calpain activation causes a proteasomedependent increase in protein degradation and inhibits the Akt signalling pathway in rat diaphragm muscle. Exp Physio. 2007; 92(3): 561–73. doi: 10.1113/expphysiol.2006.035790.

44. Hamilton G., Colbert J.D., Schuettelkopf A.W., Watts C. Cystatin F is a cathepsin C-directed protease inhibitor regulated by proteolysis. EMBO J. 2008; 27(3): 499–508. doi: 10.1038/SJ.EMBOJ.7601979.

45. Bodnar L., Wcislo G.B., Smoter M., Gasowska-Bodnar A., Stec R., Synowiec A., Szczylik C. Cystatin C as a parameter of glomerular fltration rate in patients with ovarian cancer. Kidney Blood Press Res. 2010; 33(5): 360–67. doi: 10.1159/000319097.

46. Suzuki K., Furuse H., Tsuda T., Masaki Y, Okazawa S., Kambara K., Inomata M., Miwa T., Matsui S., Kashii T., Taniguchi H., Hayashi R., Tobe K. Utility of creatinine/cystatin C ratio as a predictive marker for adverse efects of chemotherapy in lung cancer: A retrospective study. J Int Med Res. 2015; 43(4): 573–82. doi: 10.1177/0300060515579116.

47. Wilcox S.H, Calixto J., Dray S.D., Rasch D.M., Smith A.H., Brodowski K.D., Hill J.T., Thomson D.M. Chronic treatment of old mice with AICAR reverses age-related changes in exercise performance and skeletal muscle gene expression. FASEB Bioadv. 2025; 7(3): e1491. doi: 10.1096/fba.2024-00252.


Supplementary files

1. Figure. 1. Pathophysiological mechanisms underlying sarcopenia and possible therapeutic intervention points. The ubiquitin-proteasome pathway of muscle protein degradation is marked in purple; the lysosomal-autophagy pathway in green; the caspase-dependent pathway in blue; and the calcium-dependent pathway in brown. Key potential therapeutic targets are indicated by the marker 'possible intervention' on the diagram. These include activation of AMPK, inhibition of mTORC1, stimulation of anabolism via targeting the IGF-1 pathway or direct administration of IGF-1 peptides, and inhibition of NF-κB. Note: created by the authors
Subject
Type Other
View (430KB)    
Indexing metadata ▾

Review

For citations:


Bereznikova D.A., Stanoevich U.S. Biochemical markers of skeletal muscle metabolism and their clinical signifance in oncology: a literature review. Siberian journal of oncology. 2026;25(1):146-154. (In Russ.) https://doi.org/10.21294/1814-4861-2026-25-1-146-154

Views: 174

JATS XML


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1814-4861 (Print)
ISSN 2312-3168 (Online)