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

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.