Megestrol Acetate and Marinol Improve Appetite in Cancer-Associated Anorexia

Megestrol Acetate and Marinol Improve Appetite in Patients With Cancer-Associated Anorexia

According to the results of a recent study conducted by the North Central Cancer Treatment Group (NCCTG), both the hormonal agent Megestrol Acetate and the cannabinoid Marinol improved appetite in patients with cancer-associated anorexia.

Anorexia is the lack or loss of appetite, which results in the inability to eat and can lead to drastic weight loss. Anorexia can result from psychological, physical and a variety of other causes. Anorexia is a common problem in cancer patients and can compromise treatment and result in a poor prognosis for patients.

More than half of patients with advanced cancer suffer from anorexia. There are currently several ways to manage anorexia including nutritional support to increase caloric intake and the use of antiemetics to control nausea and vomiting associated with chemotherapy and radiation. In addition, orexigenic agents help to stimulate appetite and are often used to treat anorexia. There are several different types of orexigenic agents including cannabinoids, progesterones and corticosteroids.

Both Marinol and Megestrol Acetate are orexigenic agents. Marinol, an appetite stimulant, is part of a class of drugs collectively referred to as cannabinoids. Marinol is believed to stimulate appetite and directly block the cannabinoid-1 receptor in the brain that is responsible for chemotherapy-induced nausea and vomiting. Megestrol Acetate is a progesterone, or steroid hormone, that improves appetite in patients with advanced cancer.

This most recent study evaluated both Marinol and Megestrol Acetate for improving appetite in cancer patients with anorexia. The study involved 469 cancer patients with an ongoing problem of anorexia and/or weight loss. The study had three arms: one group took Megestrol Acetate, another group took Marinol and a final group took both.

The results indicated that 73% of patients taking Megestrol Acetate reported an improved appetite, compared with 47% in the Marinol group and 70% in the combination group. Megestrol Acetate did, however, cause severe side effects, with 18% of patients in the Megestrol Acetate group experiencing impotence, compared with 14% in the combination group and only 4% in the Marinol group. Furthermore, 18% of patients in the Megestrol Acetate group experienced fluid retention, compared with 13% in the combination group and 11% in the Marinol group.

The results of this study indicate that both Megestrol Acetate and Marinol stimulate appetite in patients with cancer-associated anorexia. Marinol has an additional advantage in that it is an antiemetic and is FDA-approved for the treatment of chemotherapy-induced nausea and vomiting. Clinical studies are ongoing to evaluate the effectiveness of both of these orexigenic agents and to establish optimal dosing for Marinol, as patients in this study received a low dose of Marinol.

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