Gamma-glutamyl Transferase and Triglycerides Associated with an Early Food Intake Response to Anamorelin in...

Objective To describe the proportion of patients with an early increase in food intake within 14 days of starting anamorelin and to explore pretreatment factors associated with this increase in patients with gastrointestinal cancer cachexia. Methods This was a single-center retrospective exploratory study. The primary outcome was a documented increase in food intake (defined as a ≥30% increase from baseline) within 14 days based on clinical records. Death within 14 days was considered not evaluable for the primary analysis. Exploratory logistic regression used prespecified cutoffs (GGT ≤54 IU/L and TG ≤97.5 mg/dL) with complete case analysis for TG. Patients Consecutive patients with gastrointestinal cancer who initiated anamorelin for cachexia (n=70; colorectal cancer, n=31; pancreatic cancer, n=21; gastric cancer, n=18). Among the evaluable patients (n=53), an increase was documented in 38 patients, while 15 showed no increase; TG was available in 46 evaluable patients for the primary regression models. Results In evaluable patients, gamma-glutamyltransferase (GGT) and TG levels were lower in the increase group than in the no-increase group (median GGT, 44 vs. 90 IU/L, P=0.033; median TG, 84 vs. 102 mg/dL, P=0.021). In age-adjusted models using complete TG data, GGT ≤54 IU/L and TG ≤97.5 mg/dL were associated with an early increase in food intake (OR 5.94 and 5.80). The findings were similar in the sensitivity analysis. Patients with low TG and GGT levels showed the highest response rates. Conclusion An increase in documented early food intake within 14 days was observed in approximately 70% of the evaluable patients. The associations of low pre-treatment GGT and TG levels with an early increase in food intake should be interpreted as hypothesis-generating and warrant external validation.