Is megestrol acetate helpful in treating cancer related anorexia or cachexia: Study

In individuals with advanced cancer, megestrol acetate (MA) did not seem to be helpful in alleviating anorexia/cachexia symptoms, says an article published in Journal of Clinical Medicine.

Cancer-related anorexia and cachexia are recognized to decrease quality of life and survival, yet there are few available treatments. The advantages of using megestrol acetate to increase appetite and treat anorexia/cachexia in patients with advanced malignancies are debatable, despite the fact that it is often used off-label. The goal of the current meta-analysis by Yu Liang Lim and company was to clarify the therapeutic advantages of MA in people with cancer-related anorexia/cachexia.

23 clinical studies addressing the use of MA in cancer-related anorexia were discovered after a thorough search of the EMBASE, PubMed, OVID Medline, Clinicaltrials.gov, and Google Scholar databases. Using Version 2 of the Cochrane risk-of-bias assessment (RoB 2), the available randomized, controlled trials were evaluated and found to have a moderate-to-high risk of bias. For a meta-analysis on weight change, a total of eight trials were adequate. Both high-dose (>320 mg/day) and low-dose (320 mg/day) treatments were used in the investigations.

The key findings of this study were as follow:

1. Regardless of dose, the pooled mean weight change for all cancer patients receiving MA was 0.75 kg.

2. High-dose MA patients typically had weight loss as opposed to weight gain.

3. There wasn't enough research on the changes in midarm circumference, tricep skinfold, or quality of life measures to do a meta-analysis.

4. With the exception of a significant thromboembolic risk, especially at larger dosages, MA was generally well tolerated.

In conclusion, patients with advanced malignancies did not have any appreciable weight gain after using MA. Patients that took large doses of MA (>320 mg/d) or low doses (320 mg/d) showed no difference either. Even though there was little research available for meta-analysis, MA did not seem to be linked to enhancements in quality of life indicators. Overall, it is not advised to use MA routinely for cancer-related anorexia or cachexia, while some patient subpopulations may benefit, and this should be the subject of future research.

Reference:

Lim, Y. L., Teoh, S. E., Yaow, C. Y. L., Lin, D. J., Masuda, Y., Han, M. X., Yeo, W. S., & Ng, Q. X. (2022). A Systematic Review and Meta-Analysis of the Clinical Use of Megestrol Acetate for Cancer-Related Anorexia/Cachexia. In Journal of Clinical Medicine (Vol. 11, Issue 13, p. 3756). MDPI AG. https://doi.org/10.3390/jcm11133756