Ghrelin Increases Energy Intake in Cancer Patients with Impaired Appetite: Acute, Randomized, Placebo-Controlled Trial

TLDR

Cancer patients often suffer from anorexia, and effective appetite‑stimulating therapies are urgently needed, though ghrelin has previously been shown to enhance appetite in healthy volunteers. This study aimed to test whether acute ghrelin infusion stimulates appetite in cancer patients with anorexia. In a randomized, placebo‑controlled, cross‑over trial, seven oncology patients received ghrelin or saline while energy intake from a buffet meal and meal appreciation on a visual analog scale were measured. Ghrelin increased energy intake by 31 % (P = 0.005) and meal appreciation by 28 % (P = 0.02) with no side effects, indicating it may be an effective treatment for cancer anorexia.

Abstract

There is a pressing need for more effective appetite-stimulatory therapies for many patient groups including those with cancer. We have previously demonstrated that the gastric hormone ghrelin potently enhances appetite in healthy volunteers. Here, we performed an acute, randomized, placebo-controlled, cross-over clinical trial to determine whether ghrelin stimulates appetite in cancer patients with anorexia. Seven cancer patients who reported loss of appetite were recruited from oncology clinics at Charing Cross Hospital. The main outcome measures were energy intake from a buffet meal during ghrelin or saline infusion and meal appreciation as assessed by visual analog scale. A marked increase in energy intake (31 ± 7%; P = 0.005) was observed with ghrelin infusion compared with saline control, and every patient ate more. The meal appreciation score was greater by 28 ± 8% (P = 0.02) with ghrelin treatment. No side effects were observed. The stimulatory effects of ghrelin on food intake and meal appreciation seen in this preliminary study suggest that ghrelin could be an effective treatment for cancer anorexia and possibly for appetite loss in other patient groups.