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Mechanisms of anorexia-cachexia syndrome and rational for treatment with selective ghrelin receptor agonist.

Abstract
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.
AuthorsAngela Esposito, Carmen Criscitiello, Lucia Gelao, Gabriella Pravettoni, Marzia Locatelli, Ida Minchella, Maria Di Leo, Rita Liuzzi, Alessandra Milani, Mariangela Massaro, Giuseppe Curigliano
JournalCancer treatment reviews (Cancer Treat Rev) Vol. 41 Issue 9 Pg. 793-7 (Nov 2015) ISSN: 1532-1967 [Electronic] Netherlands
PMID26386985 (Publication Type: Journal Article, Review)
CopyrightCopyright © 2015 Elsevier Ltd. All rights reserved.
Chemical References
  • Hydrazines
  • Oligopeptides
  • Receptors, Ghrelin
  • anamorelin
Topics
  • Animals
  • Anorexia (drug therapy, etiology, metabolism)
  • Cachexia (drug therapy, etiology, metabolism)
  • Humans
  • Hydrazines (pharmacology, therapeutic use)
  • Neoplasms (complications, metabolism)
  • Oligopeptides (pharmacology, therapeutic use)
  • Receptors, Ghrelin (agonists, metabolism)
  • Syndrome

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