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Studies of high-dose megestrol acetate: potential applications in cachexia
J Aisner1, N S Tchekmedyian, N Tait
1University of Maryland, Cancer Center, Baltimore 21201.
Seminars in Oncology
|April 1, 1988
Summary
Megestrol acetate effectively promotes weight gain and improves appetite in patients with cachexia, regardless of tumor type. Further research is ongoing to understand its mechanisms of action.
Area of Science:
- Oncology
- Endocrinology
- Pharmacology
Background:
- Cachexia, characterized by anorexia and muscle wasting, complicates cancer and other illnesses.
- Megestrol acetate, a progestin, has shown potential in managing weight loss and anorexia.
Purpose of the Study:
- To evaluate the efficacy of megestrol acetate in treating cachexia.
- To explore its role in hormone-sensitive and hormone-insensitive tumors.
- To investigate its potential mechanism of action.
Main Methods:
- Phase I-II study of escalating megestrol acetate doses in advanced breast cancer.
- Review of patient data, including weight changes and appetite.
- Initiation of laboratory and whole-animal studies.
Main Results:
- Over 80% of patients experienced weight gain, with 90% gaining weight after 6+ weeks.
- Median weight gain was 5.5 kg; subjective appetite improvement was common.
- Weight gain observed in both hormone-sensitive and hormone-insensitive tumors.
Conclusions:
- Megestrol acetate demonstrates potential in managing cachexia by improving appetite and promoting weight gain.
- A dose-related effect may exist, warranting further investigation.
- Understanding the anabolic mechanisms is crucial for optimizing its use.