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Cases of cachexia are increasing globally, and at present, the condition is estimated to affect nearly 1 percent of all patients. According to estimates, neatly 50 percent of all cancer patients eventually develop cachexia. Novel treatment approaches have been reported to deliver initial results. Thus, the global cancer cachexia market is projected to be driven by advancements in modern treatment systems and increasing occurrence of cachexia. North America, Europe and Japan are expected to be key markets.
Cachexia is a condition in which progressive loss of adipose tissue as well as skeletal muscle takes place; cancer cachexia is characterized by systemic inflammation, negative protein and energy balance, and an involuntary loss of lean body mass. Serious cachexia is caused by cancers such as pancreatic and gastric cancer, with affected individuals losing 10 to 20 percent of body weight. The severity of cachexia is more in men than in women. Cachexia is associated with poor functional performance, decreased response to chemotherapy, and greater mortality.
Current treatments include the administration of Megestrol acetate (active proges terone derivative), Medroxyprogesterone (active progesterone derivative) Ghrelin (gastric peptide hormone), Delta-9-tetrahydrocannabinol (cannabinoid), Melanocortin antagonists (adrenocorticotropic hormone antagonist), Thalidomide (immunomodulatory), Etanercept (immunomodulatory), Eicosapentaenoic acid/omega-3-fatty acids (lipid), Rikkun-shito (herbal Japanese medicine) , Corticosteroids (immunomodulatory), Formoterol (β2-adrenergic agonist), Erythropoetin (glycoprotein hormone), ACE inhibitors (heart medications), and β-blockers (heart medications). Combination therapy seeks to integrate diet and exercise (where possible) with medication.
Leading companies like Pfizer are conducting programs in several cachexia drug targets, with the aim of developing multi-modal interventions that target loss of appetite, weight loss, muscle wasting, and/or inflammation. Historically, cachexia treatment research could not progress as the aim was only one aspect – to reverse muscle wasting. However, Pfizer directs efforts towards multiple symptoms simultaneously. The company’s flagship cachexia program focuses on growth differentiation factor-15 (GDF-15), a cytokine, or cellular signalling protein, associated with appetite and energy regulation. GDF-15 is believed to interact with receptors in the brain linked with appetite control, leading to loss of appetite and nausea. Pfizer scientists seek to develop an antibody that blocks GDF-15 in cachexia patients to enable patients restore their appetite and gain weight. Pfizer scientists are also striving to create separate cachexia programs (to fight anorexia and weight loss) that could complement the GDF-15 antibody.
In 2021, Roche announced that the U.S. Food and Drug Administration (FDA) granted Breakthrough Device Designation to their Elecsys® GDF-15 assay as a companion diagnostic (CDx) in cancer treatment. The in vitro diagnostic immunoassay was intended to measure Growth Differentiation Factor-15 (GDF-15) in cachectic patients 18 years of age and older with solid tumours for treatment with Pfizer Inc.'s investigational drug PF-06946860.
Novel treatment methodologies such as the ghrelin receptor agonist anamorelin has delivered initial results and shown promise. Anamorelin is a selective, novel, orally active ghrelin receptor agonist. Ghrelin is an endogenous peptide produced primarily by the stomach. By binding to its receptor, ghrelin stimulates various pathways in the positive regulation of body weight, muscle mass, appetite and metabolism. In 2021, Helsinn Group and Ono Pharmaceutical Co., Ltd. announced that ONO secured approval to manufacture and market Adlumiz® (anamorelin hydrochloride) for the treatment of cancer cachexia in malignant tumors of non-small cell lung cancer, gastric cancer, pancreatic cancer or colorectal cancer in Japan. ONO possesses exclusive rights to develop and commercialize anamorelin in Japan, South Korea and Taiwan. Helsinn holds all rights in the rest of the world.
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Market Analysis by Therapeutics, Mechanism of Action, Distribution Channel, and Region:
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