Use of Ghrelin and Ghrelin Receptor Agonists in Cancer- and Chemotherapy-Induced Cachexia

Abstract

The Cancer Anorexia-Cachexia Syndrome (CACS) is present in up to 80% of cancer patients decreasing their quality of life and survival. Nevertheless, treatments for this condition are lacking. Ghrelin and its mimetics appear promising in the treatment of CACS. Ghrelin increases growth hormone/IGF-1 levels, body weight, and appetite, and decreases energy expenditure in healthy subjects. Also, animal and human studies have shown favorable anabolic effects of ghrelin in the setting of cancer. In preliminary studies, anamorelin, an orally available ghrelin mimetic, also seems to improve weight loss in cancer cachexia patients. Furthermore, in animal models of cisplatin-induced cachexia and emesis, ghrelin infusion stabilizes appetite, increases weight, and improves GI side effects. In several short-term studies ghrelin was found to be safe; however, long-term safety of ghrelin and ghrelin mimetics has not yet been fully established. In summary, more studies are needed looking into the long-term safety and efficacy of ghrelin and its mimetics in cancer patients and other chronic diseases associated with cachexia.