A randomized controlled trial evaluating the effects of anamorelin in postoperative patients with upper gastrointestinal cancer: protocol for the CLEAR-UP study

Patients undergoing curative surgery for upper gastrointestinal (UGI) cancers often experience substantial postoperative weight loss and reduction in muscle mass, one contributing factor being decreased ghrelin secretion following surgery. Anamorelin, a ghrelin receptor agonist, has been shown to improve appetite and increase lean body mass in patients with cancer cachexia; however, its efficacy in the postoperative setting has not been established. The CLEAR-UP study is a multicenter, open-label, randomized controlled trial designed to investigate the clinical effects of anamorelin in patients who have undergone curative resection for gastric or esophageal cancer. A total of 160 patients will be randomly assigned in a 1:1 ratio to receive either anamorelin (100 mg orally once daily for 12 weeks) or standard postoperative care without pharmacological intervention. Randomization will be stratified by cancer type (gastric vs. esophageal) and baseline body mass index (BMI