Tanaka Satomi, Takayama Koichi
Dept. of Pulmonary Medicine, Kyoto Prefectural University of Medicine.
Gan To Kagaku Ryoho. 2021 Aug;48(8):987-991.
Cancer cachexia is defined as a multifactorial syndrome that causes anorexia and an ongoing loss of skeletal muscle mass (with or without loss of fat mass). When patients got cachexia, the effectiveness and tolerance for anti-cancer therapy is reduced, leading to their poor prognosis. Although known as such disease, there had been no effective cure for cancer cachexia. Ghrelin is a peptide hormone that promotes appetite and improve cachexia. However, there is a limitation as a drug because its half-life is short and must be intravenous injected. Anamorelin is a first novel drug, an orally active, non- peptidic ghrelin mimetic and growth hormone secretagogue approved in Japan in January 2021. Like ghrelin, anamorelin also increases the appetite and lean body mass of patients with cancer cachexia. On the other hand, in clinical trials, there was no statistical significance for increasing the 6-minute walk test distance and recovering non-dominant hand grip strength. As for the functional recovery, a new program has been developed for non-pharmacotherapy with nutritional and exercise interventions. These 2 kinds of interventions will become effective anti-cachexia therapy. Research is also underway to produce anti-cachexia drugs other than anamorelin. Somes are already in their clinical trials. Anti-cachexia therapy will be a new option for treating advanced cancer.
癌症恶病质被定义为一种多因素综合征，可导致厌食以及骨骼肌质量持续下降（伴有或不伴有脂肪质量下降）。当患者出现恶病质时，抗癌治疗的有效性和耐受性会降低，导致预后不良。尽管被视为这样一种疾病，但癌症恶病质尚无有效的治愈方法。胃饥饿素是一种促进食欲并改善恶病质的肽类激素。然而，作为一种药物存在局限性，因为其半衰期短，且必须静脉注射。阿那莫林是第一种新型药物，一种口服活性、非肽类胃饥饿素模拟物和生长激素促分泌素，于2021年1月在日本获批。与胃饥饿素一样，阿那莫林也能增加癌症恶病质患者的食欲和瘦体重。另一方面，在临床试验中，增加6分钟步行试验距离和恢复非优势手握力方面没有统计学意义。至于功能恢复，已经制定了一项新的非药物治疗方案，包括营养和运动干预。这两种干预措施将成为有效的抗恶病质疗法。除阿那莫林外，其他抗恶病质药物的研发也在进行中。有些已经进入临床试验阶段。抗恶病质疗法将成为治疗晚期癌症的一种新选择。
