Early administration of anamorelin improves cancer cachexia in patients with gastrointestinal cancer

Abstract

Purpose: To report the efficacy of anamorelin in patients with colorectal and gastric cancer with cachexia and in those receiving systemic chemotherapy. Methods: We retrospectively collected real-world data from patients with colorectal and gastric cancer with cachexia who received anamorelin. Efficacy was assessed based on appetite improvement and body weight (BW) gain. Results: Forty-three patients with cancer and cachexia received anamorelin between June 2021 and October 2022 (23 with gastric cancer, 20 with colorectal cancer). The median observation time was 7.3 months, 25 patients were male, the median age was 71 years, the median body mass index was 19.7, and the ECOG PS 0/1/2 ratio was 4/33/6. Seven patients received best supportive care only, and 36 received concomitant chemotherapy with anamorelin. Thirty-four patients received prior chemotherapy with two or fewer regimens, while nine received three or more regimens. The median anamorelin treatment duration was 2.8 months, and overall survival (OS) from the first anamorelin administration was 7.3 months. Twenty-four and 21 patients experienced appetite improvement and BW gain, respectively, at 3 weeks, as did 20 and 15 at 12 weeks, respectively. In the multivariate analysis, anamorelin administration before second-line chemotherapy and colorectal cancer correlated with appetite improvement and BW gain after 3 weeks. Furthermore, anamorelin administration before second-line chemotherapy correlated with BW gain after 12 weeks in the univariate analysis, and OS significantly improved in patients with BW gain after 12 weeks. Conclusion: Early anamorelin contributes to appetite improvement and BW gain in colorectal and gastric cancer with cachexia.