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Reversible ST-T Segment Changes Induced by Anamorelin: A Case Report.

Hayato Akaishi1, Tomonori Makiguchi1, Yuji Ishida2

  • 1Department of Respiratory Medicine Hirosaki University Graduate School of Medicine Aomori Japan.

Respirology Case Reports
|November 10, 2025
PubMed
Summary
This summary is machine-generated.

Anamorelin, used for cancer cachexia, may cause cardiac ST-T segment changes. This case report highlights potential cardiac events, even without chest pain, emphasizing the need for early electrocardiogram monitoring in patients receiving anamorelin.

Keywords:
CYP3A4ST‐segment changesanamorelincachexiacalcium channel L‐type receptors

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Area of Science:

  • Cardiology
  • Oncology
  • Pharmacology

Background:

  • Anamorelin is approved in Japan for treating cancer cachexia.
  • Known adverse events associated with anamorelin include QT prolongation and potential fatal arrhythmias.
  • Cancer cachexia significantly impacts patient quality of life and treatment outcomes.

Purpose of the Study:

  • To report the first case of ST-T segment changes in a patient with non-small cell lung cancer treated with anamorelin.
  • To investigate the potential cardiac effects of anamorelin beyond known adverse events.
  • To highlight the importance of cardiac monitoring during anamorelin therapy.

Main Methods:

  • A case report of a male patient with non-small cell lung cancer receiving anamorelin.
  • Electrocardiogram (ECG) monitoring was performed.
  • Echocardiography and computed tomography angiography were utilized to assess cardiac structure and function.

Main Results:

  • The patient developed ST-segment elevation in lateral leads and reciprocal ST depression in inferior leads five days after initiating anamorelin.
  • These ECG changes occurred without associated chest pain or elevated cardiac enzymes.
  • The ST-T segment changes resolved gradually after discontinuation of anamorelin, returning to baseline by Day 19.

Conclusions:

  • Anamorelin may induce significant ST-T segment changes, potentially related to its weak competitive binding to L-type calcium channels.
  • Early ECG monitoring is advisable for patients treated with anamorelin, even in the absence of cardiac symptoms.
  • This case underscores the need for vigilance regarding potential cardiac adverse events associated with anamorelin therapy.