Title: Fast Fact and Concept #100: Megestrol Acetate for Cancer Anorexia Cachexia
Author(s): Salacz, Mike
Cachexia occurs in up to 80% of cancer patients. Abnormal weight loss (more than 5 - 10% of pre-morbid weight) results in significant physical and psychological morbidity and is an independent risk factor for early mortality. Attempts to treat anorexia with enteral (e.g., tube feeding) or parenteral feedings (e.g., TPN) have demonstrated limited efficacy, at the price of increased morbidity. Megestrol acetate, a synthetic progestin, has been extensively studied as an appetite stimulant.
Clinical trials have demonstrated that megestrol is:
Inui, A., Cancer Anorexia-Cachexia Syndrome: Current issues in research and management, CA Cancer J Clin 2002;52:72-91.
Jatoi, A., On appetite and its loss, Classic Papers, Supplement to JCO, Vol 21, No 9 (May 1), 2003: pp 79s-81s.
Jatoi, A., Dronabinol versus Megestrol Acetate versus Combination Therapy for Cancer-Associated Anorexia: A North Central Cancer Treatment Group Study, J Clin Oncol, Vol 20, No 2, (January 15), 2002: pp 567-573.
McQuellon, RP, Supportive use of megestrol acetate with head/neck and lung cancer patients receiving radiation therapy, Int J Radiat Oncol Biol Phys 2002; 52: 1180.
Tisdale, M.J., Biology of Cachexia, Journal of the National Cancer Institute, Vol 89, No 23, December 3, 1997.
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Creation Date: 10/2003
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