Dr Horn also gave 2 cautionary notes for interpreting the data. She explained that the higher grade 1 to 2 toxicities in patients who received anamorelin may prove to affect patient compliance. And there needs to be further research on how this agent affects the efficacy of traditional anticancer therapy.
Nagi Kumar, PhD, RD, of the Moffitt Cancer Center and Oncologic Sciences University of South Florida in Tampa, said these promising findings may be a nice addition to a multimodality approach.
“The only way we are going to cure this or treat cachexia is by working with different experts in imaging and lipid disorders, nutritionists, and also psychologists,” Dr Kumar told Cancer Therapy Advisor.
She explained that cachexia is a significant problem for not only patients with lung cancer but also those with pancreatic cancer and sarcoma and patients with late-stage cancer. It involves a cluster of symptoms: loss of muscle (skeletal and visceral) and fat, metabolic disorders, a weakness in functional status, and an impaired immune system.
She also said that because anamorelin stimulates the appetite, anti-inflammatory agents may be needed and that cannabis derivatives have been shown to be helpful, and may play a greater role in the future.
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With all of these subsequent issues that cachexia causes, Dr Kumar emphasized that it is more reversible in the initial stage.
“The later the stage, the more complex. So we need to start treating the condition in early stages if we hope to have any impact at all,” Dr Kumar said.
- Temel JS, Abernethy AP, Currow DC, et al. Anamorelin in patients with non-small-cell lung cancer and cachexia (ROMANA 1 and ROMANA 2): results from two randomised, double-blind, phase 3 trials [published online ahead of print February 19, 2016]. Lancet Oncol. doi: 10.1016/S1470-2045(15)00558-6.
- Currow DC, Abernethy AP. Anamorelin hydrochloride in the treatment of cancer anorexia-cachexia syndrome. Future Oncol. 2014;10(5):789-802.