Usefulness of oral medroxyprogesterone acetate in the management of cancer-related cachexia-anorexia syndrome

A study on the activity and tolerability of high-dose medroxyprogesterone acetate in the treatment of ACS in neoplastic patients was carried out in a series of 103 patients with advanced cancer beyond cure with standard chemotherapeutic or radiotherapeutic treatments. The treatment plan was: medroxyprogesterone acetate (MAP) 1,000 mg/day as liquid suspension orally at a single dose, for at least one month. If there was no improvement in body weight, SSA, performance status therapy was interrupted. An increase in body weight greater than or equal to 5%, in SSA score greater than or equal to 2 points, in performance status and then in quality of life were recorded as positive MAP-related events. Therapy-related toxicity was evaluated according to the WHO criteria. A mean body weight increased from 63 kg recorded before therapy to 67 kg recorded after 30 days of MAP. This difference was statistically significant (p<0.001). SSA increased from baseline value of 2.4 to 4.7, and mean performance status from 58.4 to 65. Again, these difference were highly significant (p<0.005 and p<0.001 respectively). The improvement in both mean body weight and SSA were statistically significant independent of performance status. Data presented in the present study confirm the clinical effectiveness of oral medroxy-progesterone acetate in the management of anorexia-cachexia syndrome in patients with advanced cancer resistant to systemic chemotherapy.