Abstract 543P
Background
Anamorelin (ANAM), a ghrelin receptor agonist, has been used as an anti-cachexia therapy for pancreatic cancer (PC) with cachexia in Japan since 2021, based on the results of ONO-7643-05 trial evaluating the benefits of ANAM on skeletal muscle mass, body weight and appetite. However, there are few real-world data evaluating the effects of ANAM on weight gain, appetite and skeletal muscle mass in PC patients (pts) with cachexia.
Methods
Cachexia pts with unresectable or recurrent PC who initiated ANAM between April 2021 and March 2022 at National Cancer Center Hospital and National Cancer Center Hospital East were retrospectively analyzed. Clinical data including weight and appetite were collected at baseline, 3 weeks (3W) later, and 12 weeks (12W) later after starting ANAM. Appetite was assessed using the 5 item anorexia symptoms of functional assessment of anorexia/cachexia therapy anorexia/cachexia subscale (FAACT-ACS). Skeletal muscle area on CT image at the third lumbar vertebra level was measured at baseline and after 12W of ANAM treatment to calculate the skeletal muscle mass index (SMI) (cm2/ m2).
Results
A total of 110 PC pts with cachexia received ANAM (median age: 70 years; male: 55 pts; Eastern Cooperative Oncology Group performance status 0/1/2/3/unknown: 15/70/15/6/4; prior chemotherapy regimen 0/1/2/3 or more: 11/59/25/15 pts). The discontinuation rate of ANAM was 42.7% at 3W (47/110) and 70.9% at 12W (78/110). The main reason for discontinuation of ANAM was disease worsening. FAACT-ACS score was increased in 21 of 36 evaluable pts (58%) at 3W and in 11 of 17 evaluable pts (65%) at 12W. Weight maintenance or gain was observed in 31 of 51 pts (61%) at 3W and in 15 of 28 pts (54%) at 12W. In the 29 pts who discontinued ANAM from 3 to 12W, the percentage of SMI gain at 12W was 17% (5/29). When the duration of ANAM dosing exceeded 12W, a gain in SMI for the first 12W was observed in 10 of 29 evaluable pts (34%).
Conclusions
Over half of the pts who continued ANAM for at least 3W experienced increased appetite or weight gain.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
National Cancer Center Hospital.
Funding
Has not received any funding.
Disclosure
A. Ohba: Financial Interests, Personal, Invited Speaker: Yakult, Ono, Servier, Taiho, Eisai, AstraZeneca, Guardant, MSD; Financial Interests, Personal, Advisory Board: Zymeworks; Financial Interests, Institutional, Local PI: Ono, Chugai, Novartis. H. Imaoka: Financial Interests, Personal, Invited Speaker: Yakult Honsha, AstraZeneca, Nihon Servier, Kaneka Medix, SB Kawasumi Laboratories, Boston Scientific, Novartis; Financial Interests, Personal, Advisory Board: Nihon Servier, Kaneka Medix; Financial Interests, Personal, Writing Engagement: Medico's Hirata; Financial Interests, Institutional, Local PI: Ono Pharmaceutical, Novartis, Nihon Servier. C. Morizane: Financial Interests, Personal, Advisory Board: Yakult, MSD, Servier, Boehringer Ingelheim, AstraZeneca, Taiho Pharmaceutical, Merck biopharma; Financial Interests, Personal, Invited Speaker: Novartis, Myriad Genetics, Guardant, TORAY; Financial Interests, Institutional, Coordinating PI: Yakult Honsha, Ono Pharmaceutical, Taiho Pharmaceutical, Eisai, MSD K.K., J-Pharma, AstraZeneca, Merck biopharma; Financial Interests, Institutional, Funding: Daiichi Sankyo RD Novare, Hitachi; Financial Interests, Institutional, Local PI: Boehringer Ingelheim; Financial Interests, Institutional, Research Grant: Labcorp; Financial Interests, Personal, Steering Committee Member: Boehringer Ingelheim. M. Ikeda: Financial Interests, Personal, Advisory Board: AstraZeneca, Chugai, Eisai, Nihon Servier, Novartis, Bristol Myers Squibb, MSD, Boehringer Ingelheim, Astellas Pharma, GSK; Financial Interests, Personal, Invited Speaker: AstraZeneca, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Taiho, Yakult, Teijin Pharma, AbbVie, Fujifilm Toyama Chemical, Incyte Biosciences Japan, Takeda, Ono, MSD, Taisho Pharmaceutical, Nippon Kayaku, Guardant Health Japan, Nobelpharma, EA Pharma; Financial Interests, Institutional, Coordinating PI: Bayer, Bristol Myers Squibb, Eisai, AstraZeneca, Eli Lilly Japan, Chugai Pharmaceutical, MSD, Ono, Novartis, J-Pharma, Chiome Bioscience, Nihon Servier, Delta-Fly Pharma, Syneos Health, Merus.N.V., Merck biopharma, Boehringer Ingelheim, Invitae, Nobelpharma; Financial Interests, Personal, Steering Committee Member: Chugai, Nihon Servier, Takeda, Novartis, Eisai, Rakuten Medical. T. Okusaka: Financial Interests, Personal, Advisory Board: Eisai, Nihon Servier, AstraZeneca, Fujifilm Toyama Chemical; Financial Interests, Personal, Invited Speaker: AstraZeneca, Eisai, Chugai Pharma, Nihon Servier, Incyte, Novartis, Daiichi Sankyo, Taiho, Yakult, Myriad Genetics, Kyowa Kirin, Ono; Financial Interests, Institutional, Local PI: AstraZeneca, Eisai, Bristol Myers Squibb, Incyte, Syneos Health, Chiome Bioscience, Sysmex. All other authors have declared no conflicts of interest.