INTRODUCTION
loss of skeletal muscle mass, tumor necrosis, Cachexia, cancer, inflammation, skeletal muscle loss, cancer cachexia, anorexia, muscle wasting
DISORDER, TUMOR NECROSIS, INFLAMMATION, CANCER, SYNDROME, LOSS OF SKELETAL MUSCLE MASS, PATHOGENESIS, ANOREXIA, MUSCLE WASTING
Cachexia is a disorder associated with anorexia, inflammation, and muscle wasting that frequently occurs in patients with cancer. In 2011, Fearon et al proposed that “cancer cachexia is defined as a multifactorial syndrome defined by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment.”The mechanism underlying cancer cachexia is not well understood, but various factors are thought to be intricately involved in its development. Inflammatory cytokines produced by cancer cells, such as interleukin (IL)‐1, IL‐6, and tumor necrosis factor‐α, induce skeletal muscle loss, lipolysis, and anorexia, suggesting cancer‐associated inflammation is the main pathogenesis of cancer cachexia.Ghrelin is a peptide hormone produced by endocrine cells in the stomach, and acts as a regulator of hunger and a growth hormone (GH) secretagogue.Anamorelin (ONO‐7643) is an orally active, highly selective agonist for the ghrelin receptor.To date, the efficacy and safety of anamorelin in patients subgrouped by baseline characteristics have not been well established. Although subgroup analyses of the ROMANA‐1 and ROMANA‐2 studies