MEGESTROL-ACETATE FOR ANOREXIA IN PATIENTS WITH FAR-ADVANCED CANCER -A DOUBLE-BLIND CONTROLLED CLINICAL-TRIAL

The aim of this study was to evaluate a low-dose regimen of megestrol acetate (IMA; 320 mg/day) on appetite in advanced cancer patients. Out -patients with far-advanced non-hormone responsive tumours and loss of appetite were randomised in a phase III trial, with two consecutive p hases: a 14-day double-blind placebo controlled phase (phase A) and a 76-day open phase (phase B). During phase A, patients were treated wit h MA, two 160 mg tablets/day, or placebo. In phase B, the MA dose was titrated to clinical response in both groups. Appetite, food intake, b ody weight, performance status, mood and quality of life were evaluate d with standardised measures; patients' global judgement about treatme nt efficacy was also requested. Of 42 patients entering the study, 33 (17 MA and 16 placebo) were evaluable for efficacy. The appetite score improved significantly with IMA after 7 days (P = 0.0023), and this e ffect was still significant at 14 days (P = 0.0064). Patients judged t he treatment with MA effective in 88.2% of cases (14th day), whilst pl acebo was considered effective by 25% (P = 0.0003). None of the other measures showed significant changes during treatment. The remarkable e ffect on appetite evident after 7 days, without serious side-effects, shows that MA can produce significant subjective effects at a low-dose even in patients with far-advanced disease. (C) 1998 Elsevier Science Ltd. All rights reserved.