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Effects by daily long term provision of ghrelin to unselected weight-losing cancer patients
A randomized double-blind study
Article first published online: 22 FEB 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 8, pages 2044–2052, 15 April 2010
How to Cite
Lundholm, K., Gunnebo, L., Körner, U., Iresjö, B.-M., Engström, C., Hyltander, A., Smedh, U. and Bosaeus, I. (2010), Effects by daily long term provision of ghrelin to unselected weight-losing cancer patients. Cancer, 116: 2044–2052. doi: 10.1002/cncr.24917
- Issue published online: 6 APR 2010
- Article first published online: 22 FEB 2010
- Manuscript Accepted: 27 JUL 2009
- Manuscript Revised: 25 JUN 2009
- Manuscript Received: 19 MAY 2009
- Swedish Cancer Society. Grant Number: 2014
- Swedish Research Council. Grant Number: 08712
- Assar Gabrielsson Foundation (AB Volvo)
- Jubileumskliniken Foundation
- IngaBritt and Arne Lundberg Research Foundation
- Swedish and Gothenburg Medical Societies and the Medical Faculty
- University of Gothenburg, Sahlgrenska University Hospital
- cancer cachexia;
- randomized trial;
- body composition
The short-term provision of ghrelin to patients with cancer indicates that there may be benefits from long-term provision of ghrelin for the palliative treatment of weight-losing cancer patients. This hypothesis was evaluated in a randomized, double-blind, phase 2 study.
Weight-losing cancer patients with solid gastrointestinal tumors were randomized to receive either high-dose ghrelin treatment (13 μg/kg daily; n = 17 patients) or low-dose ghrelin treatment (0.7 μg/kg daily; n = 14 patients) for 8 weeks as a once-daily, subcutaneous injections. Appetite was scored on a visual analog scale; and food intake, resting energy expenditure, and body composition (dual x-ray absorpitometry) were measured before the start of treatment and during follow-up. Serum levels of ghrelin, insulin, insulin-like growth factor 1, growth hormone (GH), triglycerides, free fatty acids, and glucose were measured. Health-related quality of life, anxiety, and depression were assessed by using standardized methods (the 36-item Short Form Health Survey and the Hospital Anxiety and Depression Scale). Physical activity, rest, and sleep were measured by using a multisensor body monitor.
Treatment groups were comparable at inclusion. Appetite scores were increased significantly by high-dose ghrelin analyzed both on an intent-to-treat basis and according to the protocol. High-dose ghrelin reduced the loss of whole body fat (P < .04) and serum GH (P < .05). There was a trend for high-dose ghrelin to improve energy balance (P < .07; per protocol). Otherwise, no statistically significant differences in outcome variables were observed between the high-dose and low-dose groups. Adverse effects were not observed by high-dose ghrelin, such as serum levels of tumor markers (cancer antigen 125 [CA 125], carcinoembryonic antigen, and CA 19-9).
The current results suggested that daily, long-term provision of ghrelin to weight-losing cancer patients with solid tumors supports host metabolism, improves appetite, and attenuates catabolism. Cancer 2010. © 2010 American Cancer Society.