Treatment of chemotherapy-induced cachexia with BST204: a multimodal validation study

Introduction Chemotherapy is a major etiology of cachexia. Ginseng products are known to have various anti-cachectic and health-promoting effects, such as inhibiting inflammation and promoting energy production. In particular, BST204, purified ginseng dry extract, contains multiple ginsenosides that can reduce chemotherapy-related fatigue and toxicity. Objectives To investigate the effects of BST204 on the alleviation of chemotherapy-induced cachexia using a multimodal approach. Methods In a CT26 mouse syngeneic colon cancer model, cachexia was predominantly induced by chemotherapy with 5-fluorouracil (5-FU) than by tumor growth. BST204 at a dose of 100 or 200 mg/kg was administered to 5-FU-treated mice. Results BST204 significantly mitigated the decrease in tumor-excluded body weight (change in 5-FU group and BST204 groups: − 13% vs. − 6% on day 7; − 30% vs. − 20% on day 11), muscle volume (− 19% vs. − 11%), and fat volume (− 91% vs. − 56%). The anti-cachectic effect of BST204 was histologically demonstrated by an improved balance between muscle regeneration and degeneration and a decrease in muscle cross-sectional area reduction. Conclusion Chemotherapy-induced cachexia was biochemically and metabolically characterized by activated inflammation, enhanced oxidative stress, increased protein degradation, decreased protein stabilization, reduced glucose-mediated energy production, and deactivated glucose-mediated biosynthesis. These adverse effects were significantly improved by BST204 treatment. Overall, our multimodal study demonstrated that BST204 could effectively alleviate chemotherapy-induced cachexia.