A novel compound developed to prevent the ravages of cancer-induced anorexia-cachexia (CACS) has for the first time demonstrated a significant improvement in lean body mass in patients with advanced cases of non-small cell lung cancer.

The therapy in question is Helsinn of Switzerland’s anamorelin, a selective agonist of the receptor that normally binds ghrelin, a signalling peptide released by the stomach responsible regulating hunger and lean body mass, as well as distribution and rate of energy use. Data from two Phase III studies were presented at the European Society of Medical Oncology meeting in Madrid last month.

In the ROMANA studies, 979 patients with advanced NSCLC and related CACS were randomised 2:1 fashion to treatment with anamorelin or placebo and followed for 12 weeks. CACS status was defined as 5% or more weight loss within the prior six months, or a BMI of below 20 kg/m2. Patients were allowed to receive chemotherapy.

Results from a pooled analysis showed that there was a statistically significant improvement in lean body mass with active drug as compared to placebo and the Helsinn drug also significantly increased body weight.

Study investigator David Currow at Flinders University in Adelaide claimed the data “represent a significant change in how we think about cancer anorexia-cachexia and therefore how we think about treatment of people with advanced cancer.

CACS is “a multifactorial problem but it is typified by the loss of lean body mass,” he told journalists at ESMO, and  “unfortunately, it’s the usual final pathway for most people with advanced cancer, and it is also the limiting factor for treating many people as their cancer advances”.

So “what we have here for the first time in more than a decade is a novel agent for CACS, and for the first time ever a therapeutic that has shown consistent benefit in people with advanced lung cancer,” concluded Dr Currow.

He was particularly stuck by the gains in lean body mass. “That is the thing that we’ve not been able to effect with before, and this has a real potential to influence cancer therapy across the oncology spectrum”.