恶病质是一种毁灭性的、多因素的，通常是不可逆转的全身综合征。它以严重体重减轻（主要是骨骼肌和脂肪组织）为特征，约50-80%的癌症患者患有该症。尽管该病主要影响骨骼肌（占体重的约40%），但恶病质是一种多器官综合征，也涉及到白色和棕色脂肪组织以及骨骼、大脑、肝、肠和心脏等器官。值得注意的是，恶病质占癌症相关死亡率的高达20%。与癌症相关的恶病质与全身性炎症、厌食和增加的能量消耗密切相关。了解这些机制至关重要，并且过去十年在这个领域取得的进展可以帮助开发新的治疗方法。在本文中，我们研究了当前有关肿瘤宏环境和微环境在癌症相关恶病质中所扮演的角色的证据，并概述了治疗该综合征的新型治疗策略。 © 2023 Springer Nature Limited。

Cachexia is a devastating, multifactorial and often irreversible systemic syndrome characterized by substantial weight loss (mainly of skeletal muscle and adipose tissue) that occurs in around 50-80% of patients with cancer. Although this condition mainly affects skeletal muscle (which accounts for approximately 40% of total body weight), cachexia is a multi-organ syndrome that also involves white and brown adipose tissue, and organs including the bones, brain, liver, gut and heart. Notably, cachexia accounts for up to 20% of cancer-related deaths. Cancer-associated cachexia is invariably associated with systemic inflammation, anorexia and increased energy expenditure. Understanding these mechanisms is essential, and the progress achieved in this area over the past decade could help to develop new therapeutic approaches. In this Review, we examine the currently available evidence on the roles of both the tumour macroenvironment and microenvironment in cancer-associated cachexia, and provide an overview of the novel therapeutic strategies developed to manage this syndrome.© 2023. Springer Nature Limited.