Anamorelin

Research Reagent · Laboratory Use Only

What does the research show about anamorelin's effects on cancer cachexia?

Clinical trials, including the Phase III ROMANA studies published in The Lancet Oncology (2016), found anamorelin significantly increased lean body mass and body weight in non-small cell lung cancer patients with cachexia. As a selective ghrelin receptor agonist, it stimulates appetite and anabolic pathways, though handgrip strength improvements were not statistically significant in all cohorts.

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The full abstract for Anamorelin is available directly via the peer-reviewed source.

Mechanistic Research SummaryCurated from PubMed

This data is for laboratory research purposes only. Not for human or animal consumption.

What is Anamorelin?

Anamorelin is a selective ghrelin receptor agonist (GHS-R1a agonist) investigated as a therapeutic agent for cancer-associated cachexia and anorexia. It functions as an orally bioavailable small molecule designed to stimulate appetite and preserve lean body mass in cachectic populations.

Mechanism of Action

Anamorelin binds to the ghrelin receptor (GHS-R1a) on hypothalamic neurons, mimicking endogenous ghrelin signaling. This activation stimulates the orexigenic (appetite-promoting) neuropeptide Y/agouti-related peptide pathways while simultaneously reducing pro-inflammatory cytokine production (IL-6, TNF-α). The dual mechanism addresses both appetite suppression and systemic metabolic dysfunction characteristic of cancer cachexia.

Observed Laboratory Results

  • Lean body mass preservation: Clinical trials demonstrated significant attenuation of skeletal muscle loss compared to placebo controls in advanced cancer patients
  • Appetite stimulation: Measurable increases in daily caloric intake and food consumption scores across multiple cancer types (NSCLC, gastric, pancreatic)
  • Inflammatory modulation: Reduced circulating levels of IL-6 and TNF-α, key drivers of cachexia-associated protein catabolism

Note: PROSPERO registration CRD420251131074 indicates this summary references systematic review protocol data. Consult original trial publications (e.g., ROMANA 1/2/3 series) for peer-reviewed efficacy and safety outcomes.

Clinical Research Parameters
10 trials4 human studies

The following data represents formally registered clinical research studies and peer-reviewed human subject research indexed in public registries. All dose ranges, endpoints, and observations below reflect published study parameters — not recommendations. For research reference only.

ClinicalTrials.gov ↗
NCT01395914
COMPLETEDPhase IIIn=513

Anamorelin HCl in the Treatment of Non-Small Cell Lung Cancer-Cachexia (NSCLC-C): An Extension Study (ROMANA 3)

The administration of Anamorelin HCl in patients with Non-Small Cell Lung Cancer-Cachexia (NSCLC-C) is expected to increase appetite, lean body mass, weight gain, and muscle strength.

Study Interventions
Anamorelin HCl, Placebo
Primary Endpoints
Percentage of Participants With Treatment-emergent Adverse Events
Study Period
2011-07 → 2015-02
NCT04844970
TERMINATEDPhase IIn=4

Anamorelin Study for Advanced Pancreatic Cancer

Multicenter, double-blind, randomized, placebo-controlled study to evaluate the efficacy and safety of anamorelin HCl. Approximately 100 subjects with advanced PDAC and cachexia will be randomized 1:1 to anamorelin HCl 100 mg or placebo, taken orally once daily (QD) for a total of 25 weeks. Subjects will be instructed to take the study drug at least 1 hour before their first meal of the day

Study Interventions
Anamorelin Hydrochloride, Placebo
Primary Endpoints
Percent Weight Change From Baseline to Week 25
Study Period
2023-04-01 → 2023-11-07
NCT00622193
COMPLETEDPhase IIn=228

Dose Range Study of Anamorelin in Patients With Non-small Cell Lung Cancer

The purpose of this study is to evaluate doses of anamorelin for safety and efficacy in patients with non-small cell lung cancer.

Study Interventions
anamorelin HCl, anamorelin HCl, placebo
Primary Endpoints
Hand grip strength and body weight
Study Period
2008-03 → 2009-12
NCT03743051
COMPLETEDPhase IIIn=318

A Study to Evaluate the Efficacy and Safety of Anamorelin HCl for the Treatment of Malignancy Associated Weight Loss and Anorexia in Adult Patients With Advanced Non-Small Cell Lung Cancer (NSCLC)

The goal of this clinical trial was to compare the efficacy and safety of anamorelin HCl (the investigational drug) to that of placebo (tablet with no drug) in patients with advanced non-small cell lung cancer and cachexia (cancer-related weight loss). The main question it aimed to answer was as follows: Do patients who receive anamorelin HCl gain more body weight and show more improvement in anor

Study Interventions
Anamorelin Hydrochloride, Placebo Oral Tablet
Primary Endpoints
Mean Change From Baseline in Body Weight Over 12 Weeks; Mean Change From Baseline in 5-item Anorexia Symptom Subscale (5-IASS) Over 12 Weeks
Study Period
2019-03-05 → 2023-02-11
NCT01387282
COMPLETEDPhase IIIn=495

Safety and Efficacy of Anamorelin HCl in Patients With Non-Small Cell Lung Cancer-Cachexia (ROMANA 2)

The administration of Anamorelin in patients with Stage III-IV non-small cell lung cancer-cachexia (NSCLC-C) is expected to increase appetite, lean body mass, weight gain, and muscle strength.

Study Interventions
Anamorelin HCl, Placebo
Primary Endpoints
Change in Lean Body Mass; Change in Handgrip Strength
Study Period
2011-07 → 2015-02
NCT03637816
ACTIVE NOT RECRUITINGPhase II / Phase IIIn=25

Anamorelin Hydrochloride in Reducing Anorexia in Patients With Advanced Non-small Cell Lung Cancer

This phase II/III trial studies how well anamorelin hydrochloride works in reducing anorexia in patients with non-small cell lung cancer that has spread to other places in the body. Anamorelin hydrochloride may help to improve patients' appetite in order to stop weight loss.

Study Interventions
Anamorelin Hydrochloride, Placebo, Questionnaire Administration
Primary Endpoints
To reach thematic saturation by qualitatively examining experiences related to anorexia at the baseline in advanced lung cancer patients with anorexia/cachexia receiving either oral Anamorelin 100 mg or placebo.
Study Period
2018-11-27 → 2026-12-31
NCT03035409
ACTIVE NOT RECRUITINGPhase IIn=129

Anamorelin Hydrochloride, Physical Activity, and Nutritional Counseling in Decreasing Cancer-Related Fatigue in Patients With Incurable Metastatic or Recurrent Solid Tumors

This phase II trial studies how well anamorelin hydrochloride, physical activity, and nutritional counseling work in decreasing cancer-related fatigue in patients with incurable solid tumors that have spread to other parts of the body or have come back. Anamorelin hydrochloride, physical activity, and nutritional counseling may help to decrease cancer-related fatigue in patients with solid tumors.

Study Interventions
Anamorelin Hydrochloride, Exercise Intervention, Laboratory Biomarker Analysis
Primary Endpoints
Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F)
Study Period
2017-02-08 → 2026-02-28
NCT03743064
COMPLETEDPhase IIIn=318

A Study to Evaluate the Efficacy and Safety of Anamorelin HCl for the Treatment of Malignancy Associated Weight Loss and Anorexia in Adult Patients With Advanced Non-Small Cell Lung Cancer (NSCLC)

The goal of this clinical trial was to compare the efficacy and safety of anamorelin HCl (the investigational drug) to that of placebo (tablet with no drug) in patients with advanced non-small cell lung cancer and cachexia (cancer-related weight loss). The main question it aimed to answer was as follows: Do patients who receive anamorelin HCl gain more body weight and show more improvement in anor

Study Interventions
anamorelin HCl, Placebo Oral Tablet
Primary Endpoints
Mean Change From Baseline in Body Weight Over 12 Weeks; Mean Change From Baseline in 5-item Anorexia Symptom Subscale (5-IASS) Over 12 Weeks
Study Period
2019-05-06 → 2022-12-27
NCT01387269
COMPLETEDPhase IIIn=484

Safety and Efficacy of Anamorelin HCl in Patients With Non-Small Cell Lung Cancer-Cachexia (ROMANA 1)

The administration of Anamorelin in patients with Stage III-IV non-small cell lung cancer-cachexia (NSCLC-C) is expected to increase appetite, lean body mass, weight gain, and muscle strength.

Study Interventions
Anamorelin HCl, Placebo
Primary Endpoints
Change in Lean Body Mass; Change in Handgrip Strength
Study Period
2011-07 → 2015-02
NCT01505764
TERMINATEDPhase IIn=10

The Role of Ghrelin in Cancer Cachexia

Cancer is often coupled with a condition called cachexia. In this condition, individuals continue to lose weight and lean body mass, which means their muscles are getting smaller and weaker. Studies have shown that cancer patients who are losing weight often are responding poorly to chemotherapy, are at greater risk of infection and have a reduced life expectancy. Also, people may not want to eat.

Study Interventions
Anamorelin HCl, Placebo
Primary Endpoints
Total Body Potassium.
Study Period
2012-06 → 2016-03

All data presented on this page is for laboratory research purposes only. Anamorelin is referenced here as a research reagent. This page does not constitute medical advice, clinical guidance, or endorsement of any compound for human or animal use. All referenced studies are available via PubMed (PMID: 41950300) and the DOI-linked journal publication. Researchers must consult applicable institutional and regulatory frameworks before conducting any protocols.