Cancer cachexia is a multi-organ, multifactorial and often irreversible syndrome affecting many patients with
cancer.
Cancer cachexia is invariably associated with
weight loss, mainly from loss of skeletal muscle and body fat, conditioning a reduced quality of life due to
asthenia,
anorexia, anaemia and
fatigue. Treatment options for treating
cancer cachexia are limited. The approach is multimodal and may include: treatment of secondary gastrointestinal symptoms, nutritional treatments,
drug, and non-
drug treatments. Nutritional counselling and physical training may be beneficial in delaying or preventing the development of
anorexia-
cachexia. However, these interventions are limited in their effect, and no definitive pharmacological treatment is available to address the relevant components of the syndrome.
Anamorelin is a first-in-class, orally active
ghrelin receptor agonist that binds and stimulates the
growth hormone secretagogue receptor centrally, thereby mimicking the appetite-enhancing and
anabolic effects of
ghrelin. It represents a new class of
drug and an additional treatment option for this patient group, whose therapeutic options are currently limited. In this review we examine the mechanisms of
anamorelin by which it contrasts catabolic states, its role in regulation of metabolism and energy homeostasis, the data of recent trials in the setting of
cancer cachexia and its safety profile.