Drug information and applications of Japan’s Anamorelin

Anamorelin (Anamorelin) is an innovative oral drug developed and marketed by Japan's Ono Pharmaceutical under the trade name Adlumiz. The main mechanism of action of this drug is to selectively activate GHS-R1a (Growth Hormone Secretory Receptor Type 1a), the Ghrelin receptor, thereby stimulating the body's appetite center and promoting the secretion of growth hormone and IGF-1 (insulin-like growth factor). Ghrelin is a "hunger hormone" secreted by the stomach and plays a key role in maintaining energy metabolism, regulating appetite and muscle protein synthesis. The original intention of developing Anamorelin was to use this physiological mechanism to help patients with cancer cachexia improve their desire to eat, gain weight and improve their quality of life.

In Japan, anamorelin was approved for marketing in 2021 for the treatment of cancer cachexia caused by unresectable or recurrent non-small cell lung cancer, gastric cancer, pancreatic cancer and colorectal cancer. The drug is mainly indicated for patients who suffer from weight loss, muscle loss and anorexia due to Cancer Cachexia. Cancer cachexia is a complex metabolic disorder. Even if the patient has adequate nutritional intake, it is difficult to regain weight through regular diet, and is often accompanied by persistent fatigue and physical decline. Anamorelin improves energy metabolism balance through dual central and peripheral mechanisms, allowing patients to better tolerate cancer treatment and maintain physical strength.

According to Japanese clinical guidelines, this drug is suitable for patients who have lost more than5% of their body weight within six months and are accompanied by symptoms such as loss of appetite, fatigue, general weakness, etc., especially those who have poor nutritional treatment effects. At the same time, if the patient's CRP is greater than 0.5mg/dL, hemoglobin is less than 12g/dL, or albumin is less than 3.2g/dL, it is also considered a typical candidate. Anamorelin is only suitable for patients who are able to take oral medications and have normal gastrointestinal function. It is not recommended for people with difficulty swallowing or digestion and absorption disorders.

Reference materials:https://pmc.ncbi.nlm.nih.gov/articles/PMC4677053/