title: Anamorelin hydrochloride for the treatment of cancer-anorexia-cachexia in NSCLC.
abstract: BACKGROUND
  Cancer anorexia-cachexia syndrome (CACS) is associated with increased morbidity and mortality. Anamorelin is a novel, orally active ghrelin receptor agonist in clinical development for the treatment of CACS in NSCLC. The aim of this review is to summarize preclinical and clinical studies evaluating anamorelin as a potential promising treatment for CACS in NSCLC.
  
  
  METHODS
  Pharmacodynamics, pharmacokinetics and metabolism, clinical efficacy, safety and tolerability of anamorelin for the treatment of CACS in NSCLC were reviewed. Anamorelin administration may lead to increases in food intake, body weight and lean body mass, and a stimulatory effect on growth hormone secretion in NSCLC patients. Anamorelin is well tolerated with no dose-limiting toxicities identified to date.
  
  
  CONCLUSIONS
  Targeting ghrelin receptors presents the advantage of potentially addressing multiple mechanisms of CACS simultaneously including appetite, muscle protein balance, adipose tissue metabolism, energy expenditure and inflammation. Clinical data suggest that anamorelin is well tolerated and it effectively increases appetite, body weight and lean mass in patients with advanced NSCLC. Long-term safety remains unknown at this time. The potential synergistic effects of anamorelin with nutritional support or exercise as well as its efficacy/safety in other tumor types are also unknown.
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine , 2002 Holcombe Blvd, Building 109, Room 210, Houston, TX 77030 USA 713 794 7989 ; 713 794 7771 ; jgarcia1@bcm.edu.
authors.forename: Hongjie
authors.initials: H
authors.lastname: Zhang
authors.forename: Jose M
authors.initials: JM
authors.lastname: Garcia
mesh_terms: D000818:Animals; D000855:Anorexia / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D001066:Appetite / Q000187:drug effects; D002100:Cachexia / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D017322:Clinical Trials, Phase II as Topic; D006801:Humans; D006834:Hydrazines / Q000494:pharmacology / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D009842:Oligopeptides / Q000494:pharmacology / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D054440:Receptors, Ghrelin / Q000819:agonists*
chemical_list: D006834:Hydrazines; D009842:Oligopeptides; D054440:Receptors, Ghrelin; C000593861:anamorelin
keywords: NSCLC; anamorelin; cancer-anorexia-cachexia syndrome; ghrelin