Anamorelin: An Oral Ghrelin-Based Drug for Cancer-Related Muscle Wasting and Appetite Loss
Anamorelin, an oral ghrelin receptor agonist, showed significant improvements in appetite, body weight, lean mass, and grip strength in cancer cachexia patients without promoting tumor growth.
Quick Facts
What This Study Found
Anamorelin hydrochloride demonstrated significant improvements across multiple cachexia endpoints in preclinical and clinical studies:
- Significant appetite enhancement via potent ghrelin receptor activation
- Improvements in body weight and lean body mass compared to placebo
- Improvements in handgrip strength (a key functional measure)
- Stimulation of growth hormone and IGF-1 secretion (anabolic effects)
Critically, the growth hormone and IGF-1 stimulation did not promote tumor growth, and overall survival was not compromised in cancer patients. The drug was well tolerated with no dose-limiting toxicities identified across studies completed at the time of this review. Phase III studies in non-small-cell lung cancer cachexia were ongoing.
Key Numbers
How They Did This
This is a review article summarizing preclinical and clinical study data for anamorelin hydrochloride in the treatment of cancer anorexia-cachexia syndrome, focusing on its application in non-small-cell lung cancer patients. The review covers pharmacology, efficacy data, safety profile, and the status of ongoing Phase III clinical trials.
Why This Research Matters
Cancer cachexia affects up to 80% of advanced cancer patients and directly contributes to mortality, yet treatment options remain extremely limited. An oral drug that can improve appetite, build lean mass, and increase strength without promoting tumor growth or requiring injections would represent a major advance in supportive cancer care. Anamorelin's ghrelin-mimicking mechanism addresses the biological root of cachexia rather than just treating symptoms.
The Bigger Picture
Ghrelin-based therapies represent a fundamentally different approach to cancer cachexia compared to appetite stimulants like megestrol acetate or corticosteroids. By targeting the ghrelin receptor, anamorelin activates both appetite and anabolic pathways simultaneously. Since this 2014 review, anamorelin has been approved in Japan for cancer cachexia and has completed Phase III trials (ROMANA studies), though it has not received FDA or EMA approval, partly because improvements in lean mass did not consistently translate to functional gains.
What This Study Doesn't Tell Us
This is a review article published while Phase III trials were still ongoing, so definitive efficacy conclusions could not be drawn. The review focuses specifically on NSCLC cachexia, and generalizability to other cancer types was not established. Long-term safety data were limited. The review does not report specific numerical results from clinical trials in the abstract.
Questions This Raises
- ?Do the improvements in lean body mass from anamorelin translate to meaningful functional and survival benefits in cancer patients?
- ?Could anamorelin be effective for cachexia in cancers other than non-small-cell lung cancer?
- ?What is the optimal timing for initiating ghrelin-based therapy in the cachexia trajectory — early intervention or after significant wasting has occurred?
Trust & Context
- Key Stat:
- No tumor growth promotion Despite stimulating growth hormone and IGF-1, anamorelin did not promote tumor growth or compromise overall survival in cancer patients — a critical safety finding for an anabolic drug used in oncology.
- Evidence Grade:
- This is a review article summarizing preclinical and early clinical data, published while Phase III trials were ongoing. It provides a comprehensive overview but does not present definitive clinical trial results.
- Study Age:
- Published in 2014, this review predates the completion of the ROMANA Phase III trials. Anamorelin has since been approved in Japan (2021) for cancer cachexia but has not received FDA or EMA approval.
- Original Title:
- Anamorelin hydrochloride in the treatment of cancer anorexia-cachexia syndrome.
- Published In:
- Future oncology (London, England), 10(5), 789-802 (2014)
- Authors:
- Currow, David C, Abernethy, Amy P
- Database ID:
- RPEP-02360
Evidence Hierarchy
Frequently Asked Questions
What is cancer cachexia?
Cancer cachexia is a severe wasting syndrome where patients lose significant weight and muscle mass, often despite eating. It affects up to 80% of advanced cancer patients, reduces quality of life, and can make it harder to tolerate treatments like chemotherapy.
How does anamorelin work?
Anamorelin mimics ghrelin, the body's natural hunger hormone, by activating ghrelin receptors. This stimulates appetite while also triggering the release of growth hormone and IGF-1, which help build muscle mass. Unlike injected ghrelin, anamorelin is taken as a daily oral pill.
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Cite This Study
https://rethinkpeptides.com/research/RPEP-02360APA
Currow, David C; Abernethy, Amy P. (2014). Anamorelin hydrochloride in the treatment of cancer anorexia-cachexia syndrome.. Future oncology (London, England), 10(5), 789-802. https://doi.org/10.2217/fon.14.14
MLA
Currow, David C, et al. "Anamorelin hydrochloride in the treatment of cancer anorexia-cachexia syndrome.." Future oncology (London, 2014. https://doi.org/10.2217/fon.14.14
RethinkPeptides
RethinkPeptides Research Database. "Anamorelin hydrochloride in the treatment of cancer anorexia..." RPEP-02360. Retrieved from https://rethinkpeptides.com/research/currow-2014-anamorelin-hydrochloride-in-the
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.