癌症恶病质吃阿那莫林有用吗？

Is it useful to take Anamorelin for cancer cachexia?

Anamorelin is useful for patients with cancer cachexia. It is approved in Japan for the treatment of cancer cachexia characterized by weight loss and anorexia. The tumor types of the target patients in the Japanese Phase III study were colorectal cancer, gastric cancer, and pancreatic cancer. As a result, maintenance and increase in LBM (lean body mass) and body weight as well as improvement in anorexia were observed, and the efficacy against colorectal cancer, gastric cancer, and pancreatic cancer-related cancer cachexia was confirmed. No events considered to be significant safety risks were observed. In summary, anamorelin is expected to provide a new treatment option for cancer cachexia for which effective treatments are not yet available.

A double-blind clinical trial (ONO-7643-04) enrolled 174 Japanese patients with unresectable stage III/IV non-small cell lung cancer (NSCLC) and cachexia. Patients were randomized to daily oral administration of anamorelin (100 mg) or placebo for 12 weeks. The primary endpoint was change from baseline LBM (measured with dual-energy x-ray absorptiometry) over 12 weeks. Secondary endpoints were changes in appetite, weight, quality of life, handgrip strength (HGS) and 6-minute walk test (6MWT) results.

Results: The least squares mean change (plus or minus standard error) in LBM from baseline over 12 weeks was 1.38±0.18 and -0.17±0.17 kg in the anamorelin and placebo groups, respectively. Both treatment groups showed significant differences in changes from baseline in LBM, weight, and anorexia symptoms at all time points. Anamorelin increased prealbumin at weeks 3 and 9. No changes in HGS or 6MWT were detected between the two groups. In patients with NSCLC, 12 weeks of anamorelin treatment was safe and well tolerated.

Conclusion: Anamorelin significantly increased LBM and improved anorexia symptoms and nutritional status, but not motor function, in Japanese patients with advanced NSCLC. Since there is currently no effective treatment for cancer cachexia, anamorelin may be a beneficial treatment option.

Cachexia, manifested by weight loss (mainly lean body mass [LBM]) and anorexia, is common in patients with advanced cancer. Anamorelin brings a new option to patients with cancer cachexia. It is recommended that patients take medication under the guidance of a doctor and receive symptomatic treatment.

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References

Katakami N, Uchino J, Yokoyama T, Naito T, Kondo M, Yamada K, Kitajima H, Yoshimori K, Sato K, Saito H, Aoe K, Tsuji T, Takiguchi Y, Takayama K, Komura N, Takiguchi T, Eguchi K. Anamorelin (ONO-7643) for the treatment of patients with non-small cell lung cancer and cachexia: Results from a randomized, double-blind, placebo-controlled, multicenter study of Japanese patients (ONO-7643-04). Cancer. 2018 Feb 1;124(3):606-616. doi: 10.1002/cncr.31128. Epub 2017 Dec 4. PMID: 29205286; PMCID: PMC5814824.