***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background In cancer patients , malnutrition is associated with treatment toxicity , complications , reduced physical functioning , and decreased survival . The Prevalence of Malnutrition in Oncology ( PreMiO ) study identified malnutrition or its risk among cancer patients making their first medical oncology visit . Innovatively , oncologists , not nutritionists , evaluated the nutritional status of the patients in this study . Methods PreMiO was a prospect i ve , observational study conducted at 22 medical oncology centers across Italy . For inclusion , adult patients ( > 18 years ) had a solid tumor diagnosis , were treatment-naive , and had a life expectancy > 3 months . Malnutrition was identified by the  Mini Nutritional Assessment ( MNA ) , appetite status with a visual analog scale ( VAS ) , and appetite loss with a modified version of Anorexia-Cachexia Subscale ( AC/S-12 ) of the  Functional Assessment of Anorexia-Cachexia Therapy ( FAACT ) . Findings Of patients enrolled ( N=1,952 ) , 51 % had nutritional impairment ; 9 % were overtly malnourished , and 43 % were at risk for malnutrition . Severity of malnutrition was positively correlated with the stage of cancer . Over 40 % of patients were experiencing anorexia , as reported in the VAS and FAACT question naire . During the prior six months , 64 % of patients lost weight ( 1–10 kg ) . Interpretation Malnutrition , anorexia , and weight loss are common in cancer patients , even at their first visit to a medical oncology center Cross-sectional surveys are a useful tool in planning health care , both in the community and in hospitals . We found that a review of routine case records did not yield sufficient information for planning palliative care services in the hospital environment , and therefore decided to conduct a cross-sectional survey involving r and om patients attending the outpatient division of the Regional Cancer Centre , Triv and rum , India . Three hundred and twelve patients were interviewed , and pain and weight loss were found to be the most prominent symptoms ( > 90 % ) . This study indicates that symptomatology has to be addressed in detail while planning palliative care services in a hospital setting . Even with its selection bias , the study provides valuable clues for the adequate organization and continuation of palliative care services Despite the importance of symptom control in the cancer population , few studies have systematic ally assessed the prevalence and characteristics of symptoms or the interactions between various symptom characteristics and other factors related to quality of life ( QOL ) . As part of a validation study of a new symptom assessment instrument , in patients and out- patients with prostate , colon , breast or ovarian cancer were evaluated using the  Memorial Symptom Assessment Scale and other measures of psychological condition , performance status , symptom distress and overall quality of life .  The mean age of the 243 avaluable patients was 55.5 years ( range 23–86 years ) ; over 60 % were women and almost two-thirds had metastatic disease . The Karnofsky Performance Status ( KPS ) score was≤80 in 49.8 % and 123 were in patients at the time of assessment . Across tumour types , 40–80 % experienced lack of energy , pain , feeling drowsy , dry mouth , insomnia , or symptoms indicative of psychological distress . Although symptom characteristics were variable , the proportion of patients who described a symptom as relatively intense or frequent always exceeded the proportion who reported it as highly distressing . The mean ( ±SD , range ) number of symptoms per patient was 11.5±6.0 ( 0–25 ) ; in patients had more symptoms than out patients ( 13.5±5.4 vs. 9.7±6.0 , p<0.002 ) and those with KPS≤80 had more symptoms than those with KPS>80 ( 14.8±5.5 vs. 9.2±4.9 , p<0.0001 ) . The number of symptoms was highly associated with heightened psychological distress and poorer quality of life ( for example , r=0.67 for the relationship with the Functional Living Index-Cancer , a QOL measure ) . These data clarify the prevalence and characteristics of cancer-related symptoms and suggest that the number of symptoms per patient may be a useful quality of life indicator Introduction Pancreatic cancer is the fourth leading cause of cancer-related death in Western countries with a poor prognosis ( 5-year survival rates , 25 % in patients after tumor resection with adjuvant treatment ;  overall , the 5-year survival rate is about 4 % ; Jemal et al. , CA Cancer J Clin , 55:10–30 , 2005 ) . Many patients develop a cachectic status during the progression of the disease , and this syndrome accounts for up to 80 % of deaths in patients with advanced pancreatic cancer . Remarkably , there are only a few data available on the impact of cachexia in patients with pancreatic cancer scheduled for tumor resection . Material and Methods Therefore , in this study , 227 consecutive patients with ductal adenocarcinoma of the pancreas were documented over an 18-month period regarding the prevalence of cachexia and its influence on perioperative morbidity and mortality with a special interest to postoperative weight gain and survival in a prospect ively design ed data base and followed up . Results In 40.5 % of the patients , cachexia was already present at the time of operation . The cachectic patients did present in a worse nutritional status , represented by lower protein , albumins , and hemoglobin levels . Despite no significant differences in tumor size , lymph node status , and CA19 - 9 levels , the resection rate in patients with cachexia was reduced ( 77.8 % vs. 48.9 % ) due to a higher rate of metastatic disease in patients with cachexia . The morbidity and in-hospital mortality revealed no significant difference . However , patients with and without cachexia lost weight after operation , and the weight gain started not until 6 months after operation . The survival in patients with cachexia was significantly reduced in patients undergoing tumor resection as well as in palliative treated patients . Conclusion Cachexia has a significant impact on survival and performance status in palliative patients as well as in patients operated for pancreatic cancer . But tumor-related cachexia is not necessarily dependent on tumor size or load and that metastatic dedifferentiation of the tumor might be a critical step in the development of tumor-associated cachexia Lenvatinib is an oral , multitargeted tyrosine kinase inhibitor of the vascular endothelial growth factor receptors 1 through 3 ( VEGFR1‐VEGFR3 ) , fibroblast growth factor receptors 1 through 4 ( FGFR1‐FGFR4 ) , platelet‐derived growth factor receptor α ( PDGFRα ) , ret proto‐oncogene ( RET ) , and v‐kit Hardy‐Zuckerman 4 feline sarcoma viral oncogene homolog ( KIT ) signaling networks implicated in tumor angiogenesis . Positive phase 1 results in solid tumors prompted a phase 2 trial in patients with advanced , radioiodine‐refractory , differentiated thyroid cancer ( RR‐DTC ) . Background : This epidemiological observational study aim ed at determining the prevalence of malnutrition in non-selected adults with cancer , to identify risk factors of malnutrition and correlate the results with length of stay and 2-month mortality . Methods : This prospect i ve multicentre 1-day study conducted in 17 French Comprehensive Cancer Centres included 1545 patients .  Body mass index ( BMI ) , weight loss ( WL ) in the past 6 months and age were routinely recorded according to the French national recommendations for hospitalised patients ; malnutrition was rated as absent , moderate or severe according to the level of WL and BMI . Age , sex , tumour site , type of hospitalisation and treatment , disease stage , World Health Organisation performance status ( PS ) and antibiotic therapy were the potential malnutrition risk factors tested . Follow-up at 2 months allowed to determine the correlation with length of stay and mortality . Results : Malnutrition was reported in 30.9 % of patients , and was rated as severe in 12.2 % . In multivariate analysis , only pre-existing obesity ( BMI ⩾30 ) , PS ⩾2 and head- and -neck or upper digestive cancers were associated with increased risk of malnutrition . Antibiotics  use was significantly higher in malnourished patients ( 35.5 vs 22.8 % ; P<0.001 ) . Severe malnutrition was independently associated with mortality . The median length of stay was 19.3±19.4 days for malnourished patients vs 13.3±19.4 days for others ( P<0.0001 ) . Conclusion : In French Comprehensive Cancer Centres , one out of three cancer patients are malnourished and this was associated with a longer length of stay . Pre-existing obesity could be identified as a new risk factor for malnutrition in our cancer patient population perhaps because of a mis identification or a delay in nutrition support in this category of patients Background : Cachexia is a condition characterized as a loss in body mass or metabolic dysfunction and is associated with several prevalent chronic health conditions including many cancers , COPD , HIV , and kidney disease , with between 10 and 50 % of patients with these conditions having cachexia . Currently there is little research into cachexia and our objective is to characterize cachexia patients , their healthcare utilization , and associated hospitalization costs . Given the increasing prevalence of chronic diseases , it is important to better underst and cachexia so that the condition can be better diagnosed and managed . Methods : We utilized one year ( 2009 ) of the Nationwide Inpatient Sample ( NIS ) . The NIS represents all inpatient stays at a r and om 20 % sample of all hospitals within the United States . We grouped cachexia individuals by primary or secondary discharge diagnosis and then compared those with cachexia to all others in terms of length of stay ( LOS ) and total cost . Finally we looked into factors predicting increased LOS using a negative binomial model . Results : We estimated US prevalence for  cachexia-related inpatient admissions at 161,898 cases . Cachexia patients were older , with an average age of 67.95 versus 48.10 years in their non-cachexia peers . Hospitalizations associated with cachexia had an increased LOS compared to non-cachexia patients ( 6 versus 3 days ) , with average costs per stay $ 4641.30 greater . Differences were seen in loss of function ( LOF ) with cachexia patients , mostly in the major LOF category ( 52.60 % ) , whereas non-cachexia patients were spread between minor , moderate , and major LOF ( 36.28 % , 36.11 % , and 21.26 % , respectively ) . Significant positive predictors of increased LOS among cachexia patients included urban hospital ( IRR=1.21 , non-teaching urban ; IRR=1.23 , teaching urban ) , having either major ( IRR=1.41 ) or extreme ( IRR=2.64 ) LOF , and having a primary diagnosis of pneumonia ( IRR=1.15 ) . Conclusion : We have characterized cachexia and seen it associated with increased length of stay , increased cost , and more severe loss of function in patients compared to those without cachexia The aim of this prospect i ve study was to investigate the incidence of weight loss in head and neck cancer patients on commencing radiotherapy treatment at a regional oncology centre . Of the 100 patients included in the study , 33 % presented with carcinoma of the larynx . Fifty-seven per cent of patients had lost weight on commencing treatment . A mean weight loss of 6.5 kg , equating to approximately 10 % of body weight , was reported . A significant number of patients experienced a dry and /or sore mouth , had difficulty masticating and swallowing food , had altered taste perception , were missing meals or had symptoms of uncontrollable nausea and constipation . Since radiotherapy treatment may further limit oral intake , it is essential that dietetic intervention is addressed for all head and neck cancer patients and incorporated into the treatment plan on diagnosis before definitive management commences Purpose : Positive results of phase I studies evaluating lenvatinib in solid tumors , including thyroid cancer , prompted a phase II trial in advanced medullary thyroid carcinoma ( MTC ) . Experimental Design : Fifty-nine patients with unresectable progressive MTC per Response Evaluation Criteria In Solid Tumors ( RECIST ) v1.0 within the prior 12 months received lenvatinib ( 24-mg daily , 28-day cycles ) until disease progression , unmanageable toxicity , withdrawal , or death . Prior anti-VEGFR therapy was permitted . The primary endpoint was objective response rate ( ORR ) by RECIST v1.0 and independent imaging review . Results : Lenvatinib ORR was 36 % [ 95 % confidence interval ( CI ) , 24%–49 % ] ; all partial responses . ORR was comparable between patients with ( 35 % ) or without ( 36 % ) prior anti-VEGFR therapy . Disease control rate ( DCR ) was 80 % ( 95 % CI , 67%–89 % ) ; 44 % had stable disease . Among responders , median time to response ( TTR ) was 3.5 months ( 95 % CI , 1.9–3.7 ) . Median progression-free survival ( PFS ) was 9.0 months ( 95 % CI , 7.0–not evaluable ) . Common toxicity criteria grade 3/4 treatment-emergent adverse events included diarrhea ( 14 % ) , hypertension ( 7 % ) , decreased appet 
    Output:
    
The absolute number of patients affected by cancer cachexia in each cancer group is lower than the defined thresholds for orphan diseases in the USA and EU .