Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo.
National Center for Geriatrics and Gerontology, Aichi.
Curr Opin Support Palliat Care. 2023 Sep 1;17(3):162-167. doi: 10.1097/SPC.0000000000000658. Epub 2023 Jun 30.
Anamorelin was approved for production and marketing in Japan on 22 January 2021 for cancer cachexia in non-small-cell lung cancer, gastric cancer, pancreatic cancer, and colorectal cancer. The authors describe the updates of anamorelin for cancer cachexia in Japan.
Recent evidence showed that anamorelin improved lean body mass, body weight, and appetite in patients with cancer cachexia in clinical practice. Anamorelin does not increase body weight in the severe-weight-loss group in cachectic patients with pancreatic cancer. Several case reports showed that anamorelin can cause cardiac adverse drug reactions. Among the cardiac adverse reactions, fatal arrhythmias should be monitored carefully even if it is the first dose. Anamorelin combined with nutrition, physical activity, and exercise may be more useful than anamorelin alone for treating cancer cachexia. An interim analysis from post-marketing all-case surveillance was performed; however, details have not yet been published. When anamorelin cannot be used for cancer cachexia, Kampo medicines can be considered as an option.
Anamorelin has changed the clinical practice of cancer cachexia in Japan. The authors hope that anamorelin is available for other disease-related cachexia along with appropriate multidisciplinary interventions.
盐酸氨基酮戊酸于 2021 年 1 月 22 日在日本获批上市,用于治疗非小细胞肺癌、胃癌、胰腺癌和结直肠癌患者的癌性恶病质。本文作者就盐酸氨基酮戊酸在日本治疗癌性恶病质的最新进展进行了描述。
近期证据表明,盐酸氨基酮戊酸可改善癌性恶病质患者的去脂体重、体重和食欲。在伴有严重体重丢失的胰腺癌恶病质患者中,盐酸氨基酮戊酸不会增加体重。一些病例报告显示,盐酸氨基酮戊酸可引起心脏药物不良反应。在心脏不良反应中,即使是首剂也应仔细监测致命性心律失常。盐酸氨基酮戊酸联合营养、体力活动和运动可能比单独使用盐酸氨基酮戊酸更有助于治疗癌性恶病质。已对上市后全病例监测进行了中期分析,但详细信息尚未公布。当盐酸氨基酮戊酸不能用于癌性恶病质时,可以考虑使用汉方药。
盐酸氨基酮戊酸改变了日本癌性恶病质的临床实践。作者希望盐酸氨基酮戊酸能与适当的多学科干预措施一起,用于治疗其他与疾病相关的恶病质。