451P - The real-world efficacy and safety of anamorelin hydrochloride for Japanese unresectable non-small cell lung cancer patients with cachexia

Background

Cancer anorexia-cachexia syndrome (CACS) can lead to impaired quality of life (QOL) and poor prognosis in advanced cancer patients. Anamorelin hydrochloride (anamorelin), an orally administered ghrelin-receptor agonist, has been approved in Japan among the first in the world for the treatment of CACS associated with advanced solid cancers including non-small cell lung cancer, gastrointestinal cancers, and pancreatic cancer. However, its efficacy and safety in clinical practice are not known well.

Methods

Unresectable non-small cell lung cancer patients treated with anamorelin were recruited in between 2021 July and 2022 December in a single institution in Japan. The characteristics of patient’s clinical background were investigated, and then the effects of anamorelin on body composition and appetite, and as well as the safety were evaluated in the real-world setting.

Results

In total, 73 patients were recruited in this study. The median age was 74 years. Fiyty-four were male, and nineteen were female. Clinical staging was as follows; 18, 37, 18 patients were at stage III, stage IV, and postoperative recurrence, respectively. ECOG performance status (PS) was; 1 in 49 cases, 2 in 19 cases, and 3 in 5 cases. The median BMI was 20.2 and the median degree of weight loss was -9.1% before anamorelin administration. Two thirds’ patients were prescribed anamorelin before 2^nd-line treatment. Overall, there was a trend toward weight gain in 4 weeks after anamorelin administration. Improvement of appetite was observed in 54 patients (74.0%). These patients showed significantly better performance status, and more favorable treatment outcome and longer survival compared with ones who did not recover their appetite (p<0.05). Adverse events were observed in 20 patients (27.0％), 10 of which were hyperglycemia.

Conclusions

Anamorelin showed significant improvement of appetite in unresectable lung cancer patients with CACS. Earlier administration may bring out the favorable effects of anamorelin. Hyperglycemia should be noted as one of frequent adverse events.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.