Hiura, Y., Takiguchi, S., Yamamoto, K., Takahashi, T., Kurokawa, Y., Yamasaki, M., . . . Doki, Y. (2012). Effects of ghrelin administration during chemotherapy with advanced esophageal cancer patients: A prospective, randomized, placebo-controlled phase 2 study. Cancer, 118, 4785–4794.doi: 10.1002/cncr.27430
To examine the effects of administration of synthetic ghrelin on appetite and oral intake in patients with advanced esophageal cancer during chemotherapy
Patients were randomized to receive either ghrelin at 3 µg/kg over 30 minutes twice daily or placebo for seven consecutive days (days 1–7 of therapy) intravenously. All patients also received the same protocol of IV fluid of 3 L/day from days 1–3 and 2 L/day from days 4–7. Appetite was scored prior to each meal. A registered dietitian determined caloric intake by measuring the weight of each dish before and after every meal.
Patients were undergoing active antitumor treatment.
The study was a placebo-controlled randomized controlled trial.
Dietary intake declined after cisplatin administration to the lowest levels on days 5–7. It took another 4–7 days for oral intake to recover and enable discharge from the hospital. The decline in dietary intake was less in the ghrelin group (p = 0.0027). On day 7, intake with ghrelin was 26.7 kcal/kg/day compared to 23.1 kcal/kg/day for those receiving placebo. Prealbumin was higher in those on ghrelin (p = 0.042), and transferrin was higher with ghrelin (p = 0.037) compared to those levels in the placebo group. The severity grades of anorexia and nausea were lower with ghrelin (< 0.02).
Findings suggest that administration of ghrelin during cisplatin-based chemotherapy was effective in reducing anorexia and maintaining caloric intake compared to placebo.
Findings suggest that ghrelin as administered in this study may be beneficial to preserve appetite and nutritional intake during chemotherapy. As done here, ghrelin and fluid administration would only be practical in an inpatient setting.