Rony Dev1, Jin Ye Yeo2
1Department of Palliative Care and Rehabilitation Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 2APM Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. APM Editorial Office, AME Publishing Company. Email: apm@amepc.org.
This interview can be cited as: Dev R, Yeo JY. Meeting the Editorial Board Member of APM: Dr. Rony Dev. Ann Palliat Med. 2025. Available from: https://apm.amegroups.org/post/view/meeting-the-editorial-board-member-of-apm-dr-rony-dev.
Expert introduction
Dr. Rony Dev (Figure 1) is an Associate Professor in the Department of Palliative Medicine and the Director of the Nutrition Rehabilitation, Anorexia-Cachexia Clinic. He has published in numerous journals regarding treatments for cancer cachexia, communication in family meetings, and risk factors for chemical coping in patients with cancer. He provides palliative care consultation regarding pain and symptom management for patients with cancer.
Figure 1 Dr. Rony Dev
Interview
APM: What initially inspired you to pursue a career in Palliative Care and Rehabilitation Medicine?
Dr. Dev: I was working as a Hospitalist in Dallas, Texas, and realized that there are limitations to Internal Medicine training. Although I was prepared to manage complex medical issues, I may not necessarily manage complex psychosocial, financial, and symptomatic burdens faced by patients, especially patients with cancer. Also, patients facing end-of-life issues were common and not necessarily easy to manage, which led me to pursue further training in symptom management and Palliative Medicine at the University of Texas at MD Anderson with Dr. Eduardo Bruera.
APM: You have published numerous publications on treatments for cancer cachexia. Could you provide a brief overview of the treatments for cancer anorexia-cachexia syndrome? Are there any emerging treatment options that hold significant promise?
Dr. Dev: Unfortunately, treatment of anorexia-cancer cachexia is mostly palliative (1). Treating symptoms that impact nutrition, known as Nutrition Impact Symptoms (2), is a critical step to allow patients to improve caloric intake and hopefully gain weight. Unfortunately, appetite stimulants such as megestrol acetate have several side effects, including deep venous thrombosis, adrenal insufficiency, and hypogonadism in male patients, and we discourage use. Olanzapine has multiple randomized-controlled trials supporting its use in the treatment of nausea due to chemotherapy, and recent trials support its use as an appetite stimulant (3). I would recommend monitoring blood sugars and QT interval while taking olanzapine, and in older patients, it may cause confusion. Ponsegromab, an investigational monoclonal antibody designed to treat cachexia by inhibiting growth differentiation factor-15 (GDF-15) in a recent phase 2 trial has shown promise in patients with lung and gastrointestinal malignancies (4), but more research is needed.
APM: What motivated you to delve into this area (treatments for cancer cachexia), and what specific gaps in treatment do you aim to address?
Dr. Dev: During my Internal Medicine training in the geriatric elective month, my attending educated me on the relationship between poor healing or pressure ulcers and loss of lean muscle mass, specifically when greater than 5%. Unfortunately, there is limited training regarding issues of nutritional health and quite a bit of misinformation. This triggered self-study in the field of functional nutrition and eventually in cancer cachexia. Although there is much basic science being done in cancer cachexia, there is a shortage of robust clinical trials and limited treatment options.
APM: Another focus of your research is on communication in family meetings. What key factors do you believe contribute to effective communication within a patient's family? Based on your research and experience, what role do you take to facilitate this process?
Dr. Dev: When I started my training in Palliative Medicine at the University of Texas MD Anderson Cancer Center, I had an interest in learning more about family conferences. My interest led to a few projects and publications, and communication is at the foundation of palliative care. In some cases, family dysfunction makes communication exceedingly difficult, and being able to communicate with the patient and family caregiver dyad is critical to make sure everyone is on the “same page” (5).
APM: Looking back on your experience in providing palliative care consultations for pain and symptom management in cancer patients, what concerns do you find are most prevalent among patients? Additionally, what aspects of providing these consultations do you find the most challenging?
Dr. Dev: Symptom management including pain, cancer fatigue, and anorexia-cachexia syndrome can be challenging to deal with. Each patient is unique and presents a challenge. Ideally, palliative care should be personalized to each patient’s unique situation. This makes providing palliative care quite difficult. A thorough assessment of symptoms as well as considering underlying co-morbidities is needed prior to treating patients, as well as evaluating the psychosocial and financial burdens they face. The biggest challenge is to “connect all the dots” for patients and family caregivers which I believe requires training in the field of Palliative Medicine.
APM: Moving forward, what legacy do you hope to leave in the field of cancer palliative care?
Dr. Dev: The biggest legacy is always the younger faculty, fellows, and students that you can not only teach but also learn from. Being a mentor for students is one of the rewards of working in an Academic setting.
APM: How has your experience been as an Editorial Board Member of APM?
Dr. Dev: Being on the editorial board of APM has been a unique learning experience. I enjoy reviewing articles and providing feedback. APM has been very patient with me. Unfortunately, due to a busy schedule, I often run behind schedule, but the APM staff have always been flexible and helpful.
APM: As an Editorial Board Member, what are your expectations for APM?
Dr. Dev: My main expectation of APM is that they continue to publish and highlight the field of Palliative Medicine. The field encompasses a wide range of psychosocial topics and areas of scientific research, such as cancer cachexia, making it challenging but enjoyable.
References
- Dev R, Wong A, Hui D, et al. The Evolving Approach to Management of Cancer Cachexia. Oncology 2017;15:31:23-32.
- Amano K, Dev R, Naito T, et al. International Survey on Consensus Definition on Nutrition Impact Symptoms in Patients with Cancer. Nutr Cancer 2025;77:210-220.
- Sandhya L, Devi Sreenivasan N, Goenka L, et al. Randomized Double-Blind Placebo-Controlled Study of Olanzapine for Chemotherapy-Related Anorexia in Patients with Locally Advanced or Metastatic Gastric, hepatopancreatobiliary, and Lung Cancer. J Clin Oncol 2023;41:2617-2627.
- Groarke JD, Crawford J, Collins SM, et al. Ponsegromab for the Treatment of Cancer Cachexia. N Engl J Med 2024;391:2291-2303.
- Dev R. Coulson L, Del Fabbro E, et al. A prospective study of family conferences: effects of patient presence on emotional expression and end-of-life discussions. J Pain Symptom Manage 2013;46:536-545.