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. 2025 Aug 21;188(17):4549-4566.e22.
doi: 10.1016/j.cell.2025.06.039. Epub 2025 Jul 21.

Functional liver genomics identifies hepatokines promoting wasting in cancer cachexia

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Functional liver genomics identifies hepatokines promoting wasting in cancer cachexia

Doris Kaltenecker et al. Cell. .
Free article

Abstract

In cancer cachexia, the presence of a tumor triggers systemic metabolic disruption that leads to involuntary body weight loss and accelerated mortality in affected patients. Here, we conducted transcriptomic and epigenomic profiling of the liver in various weight-stable cancer and cancer cachexia models. An integrative multilevel analysis approach identified a distinct gene expression signature that included hepatocyte-secreted factors and the circadian clock component REV-ERBα as key modulator of hepatic transcriptional reprogramming in cancer cachexia. Notably, hepatocyte-specific genetic reconstitution of REV-ERBα in cachexia ameliorated peripheral tissue wasting. This improvement was associated with decreased levels of specific cachexia-controlled hepatocyte-secreted factors. These hepatokines promoted catabolism in multiple cell types and were elevated in cachectic cancer patients. Our findings reveal a mechanism by which the liver contributes to peripheral tissue wasting in cancer cachexia, offering perspectives for future therapeutic interventions.

Keywords: INTACT; REV-ERB; adipose tissue wasting; cachexia; circadian clock; hepatic reprogramming; liver-secreted factors; muscle atrophy.

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Conflict of interest statement

Declaration of interests S.H. serves on the scientific advisory board of Actimed Therapeutics Ltd (UK). M.J.-H. has consulted for Astex Pharmaceuticals, Pfizer, and Achilles Therapeutics; is a member of the Achilles Therapeutics Scientific Advisory Board and Steering Committee; and has received speaker honoraria from Pfizer, Astex Pharmaceuticals, Oslo Cancer Cluster, Bristol Myers Squibb, and Genentech.

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