Abstract 521P
Background
Anamorelin hydrochloride (anamorelin) is an orally active ghrelin receptor agonist, which was approved in Japan in 2021 for the treatment of cancer cachexia. However, anamorelin is often discontinued early in clinical practice, and factors affecting its continuation remain unknown.
Methods
We retrospectively collected clinical data of patients with gastrointestinal cancers who were administered anamorelin between April and November 2021. Early discontinuation (Ed) was defined as its discontinuation within 4 weeks of initiation, and we explored clinical factors associated with the risk of Ed. The efficacy of anamorelin was compared between the continuation (Co) group and the Ed group.
Results
Of the 123 patients included in this study, 50 (40.7%) had Ed of anamorelin. The most common reasons for Ed were cancer progression (36%), followed by adverse events (30%), and insufficient efficacy (22%). Logistic regression analysis showed that age ≥75 years (OR: 4.11, 95% C.I 1.418-11.952, p=0.009), no concomitant anti-cancer agents (OR: 8.84, 95% C.I. 1.900-41.151, p=0.006), and modified GPS ≥2 (OR: 2.65, 95% C.I. 1.065-6.604, p=0.036) were significant risk factors for Ed. At 3±1 weeks after the initiation of anamorelin, the rates of patients with increased appetite (Co 50.8% vs Ed 14.3%, p=0.012) and increased food intake (Co 59.2% vs Ed 20.0%, p=0.002) were significantly higher in the Co group than Ed group. However, the rates of patients who gained body weight were not significantly different between the two groups (Co 62.3% vs Ed 48.6%, p=0.129).
Conclusions
Our results suggest importance of initiation of anamorelin in the mild phase of cancer cachexia, when anti-cancer agents are being administered, in order to avoid Ed and achieve its efficacy.
Legal entity responsible for the study
Nonprofit Organization (NPO), Hokkaido Gastrointestinal Cancer Study Group (HGCSG).
Funding
This study was financially supported by research funding of Nonprofit Organization (NPO), Hokkaido Gastrointestinal Cancer Study Group (HGCSG).
Disclosure
K. Harada, S. Kajiura, K. Sawada, K. Hatanaka, T. Ando, H. Nakatsumi, T. Muranaka. S. Sogabe, Y. Kawamoto, S. Yuki, Y. Komatsu: Financial Interests, Personal, Invited Speaker: ONO Pharmaceutical Co., Ltd. All other authors have declared no conflicts of interest.