Natural ghrelin in advanced cancer patients with cachexia, a case series

David Blum, Susanne de Wolf-Linder, Rolf Oberholzer, Michael Brändle, Thomas Hundsberger, Florian Strasser

Research output: Contribution to journalArticlepeer-review


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 
Original languageEnglish
Pages (from-to)506-516
Number of pages11
JournalJournal of Cachexia, Sarcopenia and Muscle
Issue number2
Publication statusPublished - 1 Apr 2021


  • Ghrelin
  • Cancer cachexia
  • Appetite
  • Muscle mass

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