TNF and malnutrition: The possible justification for this could be due to cancer related malnutrition (CRM) associated inflammatory mediators TNF-α, IL-2,and IL-6 inhibits serum albumin gene expression, enhance vascular permeability of plasma serum albumin clearance, and degradation of serum albumin to generate amino acid for tissue protein synthesis and low protein diet decreases serum albumin level [24].