The majority of in vivo studies showed a null or inverse association of ghrelin with risk and progression of most cancers , suggesting that ghrelin/ghrelin-receptor agonist treatment may have a favorable safety profile to use for cancer cachexia .
Ghrelin is a hormone with multiple physiologic functions , including promotion of growth hormone release , stimulation of appetite and regulation of energy homeostasis .
Treatment with ghrelin/ghrelin-receptor agonists is a prospect i ve therapy for disease-related cachexia and malnutrition .
In vitro studies have shown high expression of ghrelin in cancer tissue , although its role including its impact in cancer risk and progression has not been established .
Safety, tolerability and pharmacokinetics of intravenous ghrelin for cancer-related anorexia/cachexia: a randomised, placebo-controlled, double-blind, double-crossover study
Twenty-one adult patients were r and omised to receive ghrelin on days 1 and 8 and placebo on days 4 and 11 or vice versa , given intravenously over a 60-min period before lunch : 10 received 2 μg kg−1 ( lower-dose ) ghrelin ; 11 received 8 μg kg−1 ( upper-dose ) ghrelin . Active and total ghrelin , growth hormone ( GH ) , and insulin-like growth factor 1 levels were monitored at baseline ( 4–5 days before day 1 ) , during treatment days , and at end of study ( day 17/18 ) . Drug-related adverse events ( assessed by NCI-CTC-toxicity criteria and cardiac examination ) did not differ between ghrelin and placebo . No grade 3/4 toxicity or stimulation of tumour growth was observed . The peak increase of GH , a biological marker of ghrelin action , was 25 ng ml−1 with lower-dose and 42 ng ml−1 with upper-dose ghrelin . Morning fasting total ghrelin levels were higher ( P<0.05 ) for upper-dose patients at end of study ( 3580 pg ml−1 ) than at baseline ( 990 pg ml−1 ) . Insulin-like growth factor 1 levels did not change . At day 8 , 81 % of patients preferred ghrelin to placebo as against 63 % at the end of study . Nutritional intake and eating-related symptoms , measured to explore preliminary efficacy , did not differ between ghrelin and placebo . Ghrelin is well tolerated and safe in patients with advanced cancer .  For safety , tolerance , and patients ' preference for treatment , no difference was observed between the lower- and upper-dose group
The majority of in vivo studies showed a null or inverse association of ghrelin with risk and progression of most cancers , suggesting that ghrelin/ghrelin-receptor agonist treatment may have a favorable safety profile to use for cancer cachexia .
Ghrelin is a hormone with multiple physiologic functions , including promotion of growth hormone release , stimulation of appetite and regulation of energy homeostasis .
Treatment with ghrelin/ghrelin-receptor agonists is a prospect i ve therapy for disease-related cachexia and malnutrition .
In vitro studies have shown high expression of ghrelin in cancer tissue , although its role including its impact in cancer risk and progression has not been established .