title: Clinical development of ghrelin axis-derived molecules for cancer cachexia treatment.
abstract: OBJECTIVE
  Cachexia is a devastating complication of cancer for which there is no approved treatment. Here we review the clinical development of ghrelin and ghrelin mimetics (also known as growth hormone secretagogues or GHS) for cancer cachexia treatment.
  
  
  RESULTS
  Ghrelin, a novel hormone known to increase appetite, lean and fat mass, and growth hormone secretion, is being developed as a therapeutic option for cancer anorexia-cachexia syndrome (CACS). Recent animal studies suggest that it may also decrease inflammation and that some of its effects may be independent of its only known receptor, the GHS receptor-1a.Clinical studies recently have shown that administration of ghrelin or GHS improves appetite and quality of life as assessed by questionnaires. Weight gain, increased food intake and better tolerance to chemotherapy have also been reported. This treatment appears to be safe and well tolerated.
  
  
  CONCLUSIONS
  Ghrelin and GHS have the potential to effectively prevent or reverse CACS. Preliminary studies show improvements in weight stabilization and appetite with short-term usage. Further studies are required to fully characterize the role of ghrelin and GHS for the treatment of CACS and to establish the safety of this approach.
authors.affiliation: aDivision of Diabetes, Endocrinology and Metabolism, MCL, Center for Translational Research in Inflammatory Diseases, Michael E DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA bDepartment of Environmental Hygiene, College of Preventive Medicine, Third Military Medical University, Chongqing, China cDept of Molecular and Cell Biology and Huffington Center on Aging, Baylor College of Medicine, Houston, Texas, USA *Sumbul Ali and Ji-an Chen contributed equally to the writing of this article.
authors.forename: Sumbul
authors.initials: S
authors.lastname: Ali
authors.forename: Ji-an
authors.initials: JA
authors.lastname: Chen
authors.forename: Jose M
authors.initials: JM
authors.lastname: Garcia
mesh_terms: D000818:Animals; D001066:Appetite / Q000187:drug effects; D002100:Cachexia / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D017326:Clinical Trials, Phase III as Topic; D004195:Disease Models, Animal; D054439:Ghrelin / Q000494:pharmacology / Q000627:therapeutic use*; D013006:Growth Hormone / Q000378:metabolism*; D006801:Humans; D018482:Muscle, Skeletal / Q000187:drug effects; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D011788:Quality of Life; D054440:Receptors, Ghrelin / Q000502:physiology*; D015430:Weight Gain / Q000187:drug effects
chemical_list: D054439:Ghrelin; D054440:Receptors, Ghrelin; D013006:Growth Hormone