Why is cancer-related cachexia research important?
Research on cancer anorexia/cachexia research is incredibly important, as these are very common symptoms in patients with advanced cancer and a significant source of morbidity and mortality.
Patients with cancer anorexia/cachexia experience decreased appetite, low food intake and unintended weight loss. As a consequence of this decreased food intake and weight loss, patients have less energy and are more weak and tired. Importantly, these symptoms can also negatively affect patients’ cancer outcomes as patients with anorexia/cachexia do not tolerate chemotherapy as well as patients without these symptoms.
Can you explain the methods of the ROMANA 1 and 2 trials?
ROMANA 1 and 2 were both large, international phase III trials in which patients with advanced non-small cell lung cancer (NSCLC) and unintended weight loss were randomized to anamorelin or placebo.
The studies were designed to allow large numbers of patients with advanced non-small cell lung cancer to participate in the study. Anamorelin is administered orally so patients did not have to spend extra time in the hospital or cancer center to receive the medication. The studies were designed to evaluate the effect of anamorelin on lean body mass, handgrip strength, body weight and symptom burden in patients with advanced NSCLC.
Can you discuss the key findings from your research?
ROMANA 1 and 2 demonstrated that patients assigned to anamorelin experienced increases in lean body mass and body weight and decreases in their symptom burden. These are incredibly exciting results and a much-needed breakthrough in the management of these troubling symptoms.
Patients assigned to anamorelin did not experience improvements in their handgrip strength, which was a disappointing result. However, other studies of medications to treat cancer anorexia/cachexia have had similar results suggesting that handgrip strength may not be a sound measure in patients with advanced cancer. Importantly, anamorelin was well tolerated and patients did not experience significant side effects while taking it.
Can you talk about the significance of this research and how the study results have the potential to impact patients with cachexia in NSCLC?
The results of this research are very exciting and I hope that the results will have a significant impact on patients with non-small cell lung cancer and cachexia.
First, the study is bringing much needed attention to these under-recognized symptoms. Second, it represents an effective treatment option for patients with cancer anorexia/cachexia, which is an area where treatment options are quite limited at this time. While there are medications that increase appetite and food intake, they do not significantly impact loss of weight through decreased muscle mass, which is a key part of the morbidity of cancer anorexia/cachexia. Additionally, these medications have potentially serious side effects including thromboembolic events and adrenal insufficiency. Thus, the findings from ROMANA 1 and 2 have the potential to alter treatment paradigms for this common and troubling symptom.
Who will find these study results important and useful?
Each and every oncologist and patient with advanced cancer will find these results important and useful. Patients with cancer anorexia/cachexia and their families are always so disappointed to hear that there are no effective and safe therapies to improve these symptoms. It would be truly practice changing to have something to offer patients with these devastating symptoms.
You can access the study on the ASCO meeting library website.
Have you been involved in new and exciting research relevant to hospice and palliative care ? Email Kate at k.jackson@ehospice.com to share your news on ehospice.
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