Systematic review of the treatment of cancer-associated anorexia and weight loss.
OBJECTIVE
We systematically assessed the efficacy and safety of appetite stimulants in the management of cancer-related anorexia. Literature databases were searched for randomized controlled trials of appetite stimulants in the treatment of cancer anorexia.


METHODS
Studies were graded according to quality. Fifty-five studies met inclusion criteria.


RESULTS
Only two drugs have evidence to support their use for anorexia (progestins and corticosteroids). There is strong evidence against the use of hydrazine sulfate. The outcomes of these trials have been mixed and patient population heterogeneous.


CONCLUSIONS
The optimal dose, time to start, and duration of treatment for many appetite stimulants for cancer anorexia is still unknown. A more systematic approach to research methodology with universal outcome measure and prospective randomized studies are need. Combination regimens are needed but this cannot at the present time be supported by the data presented.
Yavuzsen
Tugba
T
Harry R. Horvitz Center for Palliative Medicine, The Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Davis
Mellar P
MP
Walsh
Declan
D
LeGrand
Susan
S
Lagman
Ruth
R
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000855:Anorexia / Q000188:drug therapy* / Q000209:etiology; D000932:Antiemetics / Q000627:therapeutic use*; D019167:Appetite Stimulants / Q000627:therapeutic use*; D006801:Humans; D008787:Metoclopramide / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications*; D011372:Progestins / Q000627:therapeutic use; D015431:Weight Loss / Q000187:drug effects*
D000305:Adrenal Cortex Hormones; D000932:Antiemetics; D019167:Appetite Stimulants; D011372:Progestins; D008787:Metoclopramide