- Impaired ECOG performance status (≥1) and elevated neutrophil-to-lymphocyte ratio (≥3.0) were independently associated with lower 12-week anamorelin treatment completion.
- Only 40.4% completed 12 weeks; continuers showed improved nutritional status, body composition, handgrip strength and anorexia-related symptoms, despite rising NLR.
- Earlier anamorelin initiation before performance status decline and systemic inflammation progression may enhance likelihood of completing 12-week treatment.
Nutr Cancer. 2026 Aug 11:1-11. doi: 10.1080/01635581.2026.2713785. Online ahead of print.
ABSTRACT
Although anamorelin improves appetite and body composition in cancer cachexia, early discontinuation is common. We aimed to evaluate predictors of 12-week treatment completion and longitudinal changes among patients who completed treatment. This single-center, retrospective study included patients with advanced gastrointestinal cancer who received anamorelin for cachexia (July 2021-March 2025). Baseline factors were compared between continuation and discontinuation groups, and predictors were assessed using multivariable logistic regression. Of 89 eligible patients, 36 (40.4%) completed 12 wk of treatment. In multivariable analyses, Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥1 (OR, 0.39; 95% CI, 0.15-0.98; p = 0.048) and neutrophil-to-lymphocyte ratio (NLR) ≥3.0 (OR, 0.35; 95% CI, 0.12-0.95; p = 0.047) were associated with lower treatment completion. In another model, NLR ≥3.0 remained significantly associated with lower treatment completion, while concurrent systemic anticancer therapy at anamorelin initiation showed a nonsignificant association with treatment completion (OR, 4.42; 95% CI, 0.92-43.07; p = 0.064). In the continuation group, nutritional status, body composition, handgrip strength, and anorexia-related symptoms improved, whereas NLR increased. Impaired ECOG PS and elevated NLR were associated with failure to complete 12-week anamorelin treatment. Earlier initiation of anamorelin before performance status declines and systemic inflammation progresses may support treatment completion.
PMID:42578447 | DOI:10.1080/01635581.2026.2713785
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