A case of frailty and rectal cancer with pelvic abscess treated with a combination of anamorelin hydrochloride and exercise therapy enabling radical surgery and ADL recovery

Abstract

Anamorelin hydrochloride has been reported to improve appetite and increase lean body mass. However, several studies suggest that treatment with anamorelin hydrochloride alone may be insufficient to restore muscle strength. Evidence for the effectiveness of combining anamorelin hydrochloride with exercise therapy for improving physical function is inconsistent. Herein, we report a 71-year-old male with advanced rectal cancer who presented with frailty syndrome. Upon admission, he was bedridden with a serum transthyretin (TTR) level of 4.5 mg/dL, rendering radical surgery unfeasible. Although a colostomy was performed following nutritional infusion and rehabilitation, his dietary intake did not improve. The patient was then treated with a combination of ongoing rehabilitation and anamorelin hydrochloride, which led to an improvement in his nutritional status and enabled the implementation of radical treatment. He was able to maintain continuous oral intake after cessation of anamorelin hydrochloride. Between colostomy and discharge, his TTR improved from 14.5 mg/dL to 21.6 mg/dL, and his grip strength increased from 9.5 kg to 17.6 kg. As a result, he regained the ability to walk independently and was discharged home.