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Predictors of response to anamorelin in gastrointestinal cancer patients with cachexia: a retrospective study

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Abstract

Purpose

Anamorelin, a ghrelin receptor agonist, has recently been approved for gastric, pancreatic, and colorectal cancer patients with cachexia in Japan. However, only few studies have investigated the predictors of response to anamorelin in clinical settings. Thus, our study aimed to investigate the predictors of the response, in addition to its efficacy and safety.

Methods

The clinical outcomes of 20 patients were evaluated during administration. They were divided into two groups based on lean body mass, responders and non-responders, and their clinical characteristics were compared.

Results

The mean ± standard error (SE) variations at 12 weeks in lean body mass and handgrip strength were 2.63 ± 0.79 kg and − 1.53 ± 1.20 kg, respectively. The mean ± SE variations at 8 weeks in fasting blood glucose and hemoglobin A1c were 32.88 ± 13.77 mg/dL and 0.90 ± 0.18%, respectively. Total protein, albumin, transferrin, and prognostic nutritional index at baseline were significantly higher in responders (n = 8) than in non-responders (n = 12), whereas the neutrophil/lymphocyte and C-reactive protein/albumin ratios at baseline were significantly higher in non-responders than in responders.

Conclusion

The study confirmed the efficacy and safety of anamorelin and identified nutritional or systemic inflammatory markers as predictors of anamorelin response in advanced gastrointestinal cancer patients.

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Data Availability

The data in this article is available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to thank all members of the Department of Gastroenterology and Hepatology, Fukuchiyama City Hospital.

Funding

This work was supported by a Grant-in-Aid for Early-Career Scientists from the Japanese Society for the Promotion of Science KAKENHI (grant no. 22K16051) to Naoto Iwai.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Fukuchiyama City Hospital, 231 Atsunaka-Cho, Fukuchiyama City, Kyoto, 620-8505, Japan

    Naoto Iwai, Hiroaki Sakai, Kohei Oka, Junichi Sakagami, Takashi Okuda, Chie Hattori, Masashi Taniguchi, Tasuku Hara, Toshifumi Tsuji, Toshiyuki Komaki & Keizo Kagawa

  2. Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Naoto Iwai, Junichi Sakagami, Masashi Taniguchi, Keizo Kagawa, Toshifumi Doi, Takeshi Ishikawa, Hiroaki Yasuda & Yoshito Itoh

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  1. Naoto Iwai
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Contributions

Conceptualization, Naoto Iwai, Junichi Sakagami, and Takashi Okuda. Methodology, Naoto Iwai and Junichi Sakagami. Formal analysis and investigation, Naoto Iwai, Hiroaki Sakai, Kohei Oka, Takashi Okuda, Chie Hattori, and Masashi Taniguchi. Writing—original draft preparation, Naoto Iwai. Writing—review and editing, Naoto Iwai, Junichi Sakagami, Keizo Kagawa, Toshifumi Doi, Takeshi Ishikawa, Hiroaki Yasuda, and Yoshito Itoh; Resources, Naoto Iwai, Hiroaki Sakai, Kohei Oka, Takashi Okuda, Chie Hattori, Masashi Taniguchi, Tasuku Hara, Toshifumi Tsuji, and Toshiyuki Komaki; Supervision, Keizo Kagawa, Takeshi Ishikawa, Hiroaki Yasuda, and Yoshito Itoh. Final approval of manuscript, all authors.

Corresponding author

Correspondence to Naoto Iwai.

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Competing interests

Takeshi Ishikawa and Toshifumi Tsuji received honoraria from Ono Pharmaceutical Co., Ltd. The company had no role in the study design; in the data collection, analysis, or interpretation; or in writing the draft.

Ethics approval

This study complied with the Declaration of Helsinki and was approved by the Ethics Committees of Fukuchiyama City Hospital (approval number: 3–66).

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Informed consent was obtained from all patients by the opt-out method.

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Iwai, N., Sakai, H., Oka, K. et al. Predictors of response to anamorelin in gastrointestinal cancer patients with cachexia: a retrospective study. Support Care Cancer 31, 115 (2023). https://doi.org/10.1007/s00520-023-07576-y

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