Please use this identifier to cite or link to this item:
https://doi.org/10.21256/zhaw-21359
Publication type: | Article in scientific journal |
Type of review: | Peer review (publication) |
Title: | Natural ghrelin in advanced cancer patients with cachexia : a case series |
Authors: | Blum, David de Wolf-Linder, Susanne Oberholzer, Rolf Brändle, Michael Hundsberger, Thomas Strasser, Florian |
et. al: | No |
DOI: | 10.1002/jcsm.12659 10.21256/zhaw-21359 |
Published in: | Journal of Cachexia, Sarcopenia and Muscle |
Volume(Issue): | 12 |
Issue: | 2 |
Page(s): | 506 |
Pages to: | 516 |
Issue Date: | 15-Jan-2021 |
Publisher / Ed. Institution: | Wiley |
ISSN: | 2190-5991 2190-6009 |
Language: | English |
Subjects: | Appetite; Cancer cachexia; Ghrelin; Muscle mass |
Subject (DDC): | 616: Internal medicine and diseases |
Abstract: | Background: Natural ghrelin, a peptide growth hormone secretagogue, has a therapeutic potential in cachexia. We designed a dose‐finding trial of subcutaneous natural ghrelin to improve nutritional intake (NI) in advanced cancer patients. Methods: Advanced cancer patients with cachexia management (symptom management, physiotherapy, nutritional, and psychosocial support) started with ghrelin at 32 μg/kg body weight, followed by 50% dose increases. Patients self‐injected ghrelin twice daily for 4 days followed by a wash‐out period. After reaching the primary endpoint, maximal NI (minimal dose for maximal NI), a maintenance period followed during which patients injected 10 doses of ghrelin per week. Safety parameters, NI, and cachexia outcomes (symptoms, narratives, muscle mass, and strength) were measured over 6 weeks. Results: Ten patients with metastatic solid tumours were included, and six (100% male, mean age 61.8 ± 8.5 SD) received ghrelin. Minimal dose for maximal NI was reached in four patients. Three patients reached the end‐of study visit. Ghrelin was well tolerated with variable results on appetite and eating‐related symptoms but a positive effect in the narratives. Mean Functional Assessment of Appetite & Cachexia Therapy score was 6.8 points lower at final measurement compared with baseline, t(5) = 5.98, P < .01. Muscle mass was stable in two patients and increased in one patient, and muscle strength was stable in three patients. Subjective tolerability was high. Patients showed a fluctuating trajectory, and median survival was 88 days (51–412 days). Conclusions: Ghrelin was safe in advanced patients with cancer cachexia without dose‐limiting toxicity and well tolerated. The intervention was very complex, and the number of patients included was small. There was a positive effect on nutritional intake and patient narratives. |
URI: | https://digitalcollection.zhaw.ch/handle/11475/21359 |
Fulltext version: | Published version |
License (according to publishing contract): | CC BY 4.0: Attribution 4.0 International |
Departement: | School of Health Sciences |
Organisational Unit: | Institute of Nursing (IPF) |
Appears in collections: | Publikationen Gesundheit |
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File | Description | Size | Format | |
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2021_Blum_etal_Natural-ghrelin-in-advaned-cancer-patients_jcsm.pdf | 443.42 kB | Adobe PDF | View/Open |
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Blum, D., de Wolf-Linder, S., Oberholzer, R., Brändle, M., Hundsberger, T., & Strasser, F. (2021). Natural ghrelin in advanced cancer patients with cachexia : a case series. Journal of Cachexia, Sarcopenia and Muscle, 12(2), 506–516. https://doi.org/10.1002/jcsm.12659
Blum, D. et al. (2021) ‘Natural ghrelin in advanced cancer patients with cachexia : a case series’, Journal of Cachexia, Sarcopenia and Muscle, 12(2), pp. 506–516. Available at: https://doi.org/10.1002/jcsm.12659.
D. Blum, S. de Wolf-Linder, R. Oberholzer, M. Brändle, T. Hundsberger, and F. Strasser, “Natural ghrelin in advanced cancer patients with cachexia : a case series,” Journal of Cachexia, Sarcopenia and Muscle, vol. 12, no. 2, pp. 506–516, Jan. 2021, doi: 10.1002/jcsm.12659.
BLUM, David, Susanne DE WOLF-LINDER, Rolf OBERHOLZER, Michael BRÄNDLE, Thomas HUNDSBERGER und Florian STRASSER, 2021. Natural ghrelin in advanced cancer patients with cachexia : a case series. Journal of Cachexia, Sarcopenia and Muscle. 15 Januar 2021. Bd. 12, Nr. 2, S. 506–516. DOI 10.1002/jcsm.12659
Blum, David, Susanne de Wolf-Linder, Rolf Oberholzer, Michael Brändle, Thomas Hundsberger, and Florian Strasser. 2021. “Natural Ghrelin in Advanced Cancer Patients with Cachexia : A Case Series.” Journal of Cachexia, Sarcopenia and Muscle 12 (2): 506–16. https://doi.org/10.1002/jcsm.12659.
Blum, David, et al. “Natural Ghrelin in Advanced Cancer Patients with Cachexia : A Case Series.” Journal of Cachexia, Sarcopenia and Muscle, vol. 12, no. 2, Jan. 2021, pp. 506–16, https://doi.org/10.1002/jcsm.12659.
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