NFKB1 and malnutrition: It is speculated that low muscle mass and malnutrition could be explained in part by chemotherapy agents such as cisplatin, doxorubicin, and etoposide (all used in NB2004 protocols), which directly activate NF-kB, causing muscle degradation (6) and chemotherapy side effects, such as diarrhea, vomiting, and mucositis, limiting food intake and increasing fluid loss (5).