1446P - Anamorelin in cachectic patients with non-small cell lung cancer (NSCLC) and acute phase protein reaction (APPR): Pooled analysis of two phase 3 tr...

Date 09 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Supportive Measures
Presenter David Currow
Citation Annals of Oncology (2016) 27 (6): 497-521. 10.1093/annonc/mdw390
Authors D. Currow1, J. Temel2, A. Abernethy3, J. Friend4, R. Giorgino5, K.C. Fearon6
  • 1Discipline Of Palliative And Supportive Services, Flinders University, 5041 - Adelaide/AU
  • 2Hematology/oncology, Massachusetts General Hospital Cancer Center, Boston/US
  • 3-, Flatiron Health, New York/US
  • 4R&d, Helsinn Therapeutics (US), Inc, Iselin/US
  • 5R&d, Helsinn Healthcare SA, Pambio-Noranco/CH
  • 6Surgery, Royal Infirmary, Edinburgh/GB



Cancer anorexia-cachexia frequently occurs in NSCLC patients, may be accompanied by systemic inflammation, and results in reduced muscle/lean body mass (LBM) and decreased appetite. The randomized, phase 3, double-blind ROMANA 1 (NCT01387269; N = 484) and ROMANA 2 (NCT01387282; N = 495) trials in cachectic NSCLC patients demonstrated that the ghrelin receptor agonist anamorelin improved LBM, body weight, fat mass (FM), and symptom burden compared with placebo, and was well tolerated. This analysis compared the efficacy of anamorelin in patients with or without an APPR (C-reactive protein [CRP] >10 or ≤10 mg/L, respectively).


Patients with stage III/IV NSCLC and cachexia (≥5% weight loss during prior 6 months or body mass index


An APPR was observed at baseline in approximately 64% of patients enrolled, with similar proportions between the 2 arms and no clear difference in change from baseline in CRP over 12 weeks (anamorelin: 0.5 ± 44.4 mg/L; placebo: –6.8 ± 48.20 mg/L). In anamorelin- vs placebo-treated patients, consistent increases in LBM were seen both in patients with an APPR (1.55 kg [1.02–2.07]; p 


Anamorelin does not influence APPR and leads to consistent improvements in LBM, FM and A/CS symptoms of patients regardless of APPR status.

Clinical trial identification

ROMANA 1: NCT01387269; ROMANA 2: NCT01387282

Legal entity responsible for the study

Helsinn Therapeutics


Helsinn Therapeutics


D. Currow: Advisory board (unpaid): Helsinn. Consultant, intellectual property: Mayne Pharma. Consultant: Specialist Therapeutics Australia Pty. Ltd. A. Abernethy: Stock ownership: Athena Health, Inc; Flatiron Health; Orange Leaf Associates. Advisory board: Bristol-Myers Squibb; Helsinn Therapeutics. Board of directors: Athena Health, Inc. Employee of Flatiron Health and leadership of Athena Health, Inc. J. Friend: Employee: Helsinn Therapeutics (US), Inc. Patents, royalties, other intellectual property: Helsinn Therapeutics (US), Inc. R. Giorgino: Employee: Helsinn. Patents, royalties, other intellectual property: Helsinn. K.C. Fearon: Advisory board: Helsinn. Corporate-sponsored research: grants received from Helsinn. Honorarium received from Helsinn. All other authors have declared no conflicts of interest.