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Predictors of 12-Week Anamorelin Treatment Continuation in Gastrointestinal Cancer Cachexia: A Single-Center,
Makoto Hasegawa1,2, Yohei Sanmoto1,3, Miori Endo4
1Department of Surgery, Takeda General Hospital, Aizuwakamatsu, Japan.
Nutrition and Cancer
|August 11, 2026
Summary
Anamorelin treatment for cancer cachexia is often stopped early. Poor performance status and high neutrophil-to-lymphocyte ratio predict discontinuation, suggesting earlier treatment may improve completion rates.
Area of Science:
- Oncology
- Clinical Nutrition
- Pharmacology
Background:
- Cancer cachexia significantly impacts patient outcomes and quality of life.
- Anamorelin is a ghrelin receptor agonist shown to improve appetite and body composition.
- Early discontinuation of anamorelin treatment limits its therapeutic potential.
Purpose of the Study:
- To identify predictors of 12-week anamorelin treatment completion in patients with advanced gastrointestinal cancer.
- To examine longitudinal changes in nutritional status and body composition among patients who completed the treatment.
Main Methods:
- Retrospective single-center study of 89 patients with advanced gastrointestinal cancer receiving anamorelin.
- Comparison of baseline factors between treatment continuation and discontinuation groups.
- Multivariable logistic regression analysis to identify predictors of treatment completion.
Main Results:
- Only 40.4% of patients completed 12 weeks of anamorelin treatment.
- Impaired Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥1 and elevated neutrophil-to-lymphocyte ratio (NLR) ≥3.0 were associated with lower treatment completion.
- Patients who completed treatment showed improvements in nutritional status, body composition, and anorexia symptoms, but experienced an increase in NLR.
Conclusions:
- ECOG performance status and NLR are significant predictors of anamorelin treatment failure.
- Initiating anamorelin earlier, before significant performance status decline or systemic inflammation, may enhance treatment adherence and efficacy.
