Medical Marijuana Helpful for Cancer-Linked Symptoms

“Cannabis and cannabinoid pharmaceuticals can be helpful for nausea and vomiting, pain, and weight loss associated with cancer, according to research published online Dec. 10 in CA: A Cancer Journal for Clinicians.

“John L. Kramer, M.D., from the American Cancer Society in Atlanta, reviewed evidence for medical uses of marijuana and cannabinoids.

“Kramer notes that marijuana and cannabinoids are used for nausea and vomiting, pain, and for treatment of poor appetite and weight loss. Cannabinoids may also have a role as antineoplastic agents. More high-quality studies of marijuana and cannabinoid pharmaceuticals are necessary to elucidate the various strains of marijuana and their bioactive compounds. Studies should also explore how best to administer marijuana and its bioactive components; differences are noted in pharmacokinetics between oral ingestion and inhalation and there may be variations in clinical effect for different indications. For example, inhalation may be better for treatment of nausea and vomiting. However, smoked marijuana contains carcinogens, and may cause injury to lungs. Marijuana also has acute effects on neuropsychiatric test performance.”


New Data on Fatigue from ROMANA 1, a Pivotal Phase III Study of Anamorelin in Advanced NSCLC Patients with Cachexia Presented at 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology

The gist: A new drug called anamorelin might help people with advanced non-small cell lung cancer (NSCLC) who are dealing with cachexia. Cachexia is loss of weight and muscle mass, and weakness. Anamorelin was tested in a clinical trial with volunteer patients who had advanced NSCLC and were suffering from cachexia. The drug appeared to increase the patients’ “lean body mass and body weight, reduce fatigue and improve health-related quality of life.”

“In ROMANA 1, a pivotal Phase III study, anamorelin was shown to increase lean body mass and body weight, reduce fatigue and improve health-related quality of life in patients with advanced NSCLC cachexia.

“Helsinn Group, the Company focused on building quality cancer care, announces that anamorelin, its investigational novel once-daily ghrelin receptor agonist for the treatment of cancer anorexia-cachexia syndrome (CACS), delivered significant improvements in lean body mass [LBM; one of two primary endpoints] in ROMANA 1, a pivotal 12-week Phase III study in non-small cell lung cancer (NSCLC) patients.

“The results underscore the potential for treatment with anamorelin to support the care of patients with CACS, a poorly-understood and debilitating condition that affects a majority of advanced cancer patients but for which existing treatment approaches are limited.

“In the ROMANA 1 trial, over the course of the study, patients treated with anamorelin demonstrated an increase in body weight along with improvements in patient symptoms and concerns, such as appetite, early satiety and fatigue.”


ESMO 2014: Novel Oral Agent Treats Cancer-Related Cachexia in Non–Small Cell Lung Cancer

“For the first time, studies show that a drug is effective in treating cancer-related cachexia. Oral anamorelin hydrochloride increased lean body mass, achieved weight gain, and improved quality of life in patients with cancer-related cachexia in two pivotal phase III studies presented at the ESMO 2014 Congress in Madrid, Spain (Abstract 1483O_PR).

“ ‘Cachexia is one of the most troubling symptoms of cancer for patients and their families. This is a very exciting study. For the first time in more than a decade, a drug is effective in treating cachexia. This will significantly change how we think about cancer-related cachexia and how we treat patients with cancer,’ said study coauthor David Currow, MD, of Flinders University, Adelaide, Australia.

“Anamorelin is a first-in-class oral agonist at the ghrelin receptor agonist. Release of ghrelin stimulates multiple pathways that regulate body weight, lean body mass, appetite, and metabolism.

“Patients with cancer-related cachexia keep losing weight and have no appetite. They are often too sick to get the cancer treatment that they need. A drug such as anamorelin may allow patients to be well enough to continue with their cancer treatment.”


Steroids in Advanced Cancer Don't Help Pain But Boost QOL

The gist: A clinical trial with volunteer patients tested a potentially pain-relieving treatment for people with advanced cancer. The treatment combines opioid therapy (a standard treatment for pain) with a drug called methylprednisolone. The researchers found that the addition of methylprednisolone to opioid therapy did not lessen pain compared to opioid therapy alone, but it boosted quality of life—”less fatigue, better appetite, and better overall satisfaction with their treatment.”

“For patients with advanced cancer, the addition of methylprednisolone to opioid therapy did not help control pain, but it did boost quality of life, according to results from a small randomized trial. Patients who received the corticosteroid reported less fatigue, better appetite, and better overall satisfaction with their treatment than those who did not.

“In the study, patients who received methylprednisolone 16 mg twice daily for 7 days had a lower pain-intensity score (measured on a 10-point scale) than those who received placebo (mean difference, –0.08; P = .88).

“There was no significant difference in pain intensity between the groups at baseline (mean difference, –0.48; P = .50), and no difference in opioid use.

“The study was published online July 7 in the Journal of Clinical Oncology.”


Multimodal Approach Appears Promising for Treatment of Cancer Cachexia

“Cancer cachexia is a complex, multifactorial metabolic syndrome characterized by weight and muscle loss with or without loss of fat mass.

“It occurs in 30% to 80% of patients with cancer, and it is identified as an independent predictor of shorter survival and increased risk for treatment failure and toxicity…

“Due to the lack of selectivity of anabolic androgens, a need for more selective anabolic agents has emerged, resulting in the development of nonsteroidal selective androgen receptor modulators (SARMs). These agents have the potential to elicit beneficial anabolic effects while avoiding many of the side effects observed with steroidal agents.”


Multimodal Approach Appears Promising for Treatment of Cancer Cachexia

“Cancer cachexia is a complex, multifactorial metabolic syndrome characterized by weight and muscle loss with or without loss of fat mass.

“It occurs in 30% to 80% of patients with cancer, and it is identified as an independent predictor of shorter survival and increased risk for treatment failure and toxicity…

“Due to the lack of selectivity of anabolic androgens, a need for more selective anabolic agents has emerged, resulting in the development of nonsteroidal selective androgen receptor modulators (SARMs). These agents have the potential to elicit beneficial anabolic effects while avoiding many of the side effects observed with steroidal agents.”


Multimodal Approach Appears Promising for Treatment of Cancer Cachexia

“Cancer cachexia is a complex, multifactorial metabolic syndrome characterized by weight and muscle loss with or without loss of fat mass.

“It occurs in 30% to 80% of patients with cancer, and it is identified as an independent predictor of shorter survival and increased risk for treatment failure and toxicity…

“Due to the lack of selectivity of anabolic androgens, a need for more selective anabolic agents has emerged, resulting in the development of nonsteroidal selective androgen receptor modulators (SARMs). These agents have the potential to elicit beneficial anabolic effects while avoiding many of the side effects observed with steroidal agents.”