In the clinical management of cancer and AIDS, treatment extends beyond interventions targeting the primary disease. A patient’s nutritional status often determines treatment tolerance and overall quality of life. When cachexia-related symptoms such as anorexia and rapid weight loss occur, they not only intensify physical and psychological distress but may also lead to treatment interruption and shortened survival. DengyuePharma has observed that the introduction of Megace® (Megestrol Acetate Oral Suspension), powered by innovative nanocrystal technology, provides a precise and highly effective solution for nutritional improvement in these patients, representing a major breakthrough in the treatment of Cancer Anorexia–Cachexia Syndrome (CACS).

Core Product Positioning: Focused on Cachexia, Addressing an Unmet Clinical Need

Megace® (Megestrol Acetate Oral Suspension) is a high-concentration nanocrystal formulation developed and manufactured by Changchun GeneScience Pharmaceutical and was first launched in mainland China on May 8, 2021. It is currently the only product under this generic name available on the market in China. As a third-generation megestrol acetate upgraded with nanocrystal technology, Megace® is strategically positioned to address two critical patient populations:

1. patients with AIDS-related anorexia, and

2. patients with AIDS or cancer experiencing significant weight loss due to cachexia.

In particular, for patients with Cancer Anorexia–Cachexia Syndrome (CACS), Megace® is the first nanocrystal-based drug with clearly defined indications and standardized dosing, filling a major gap in this therapeutic field.

Notably, the prevalence of CACS in China is as high as 37%, with approximately 1.79 million new cases annually. Among patients with advanced malignancies, prevalence exceeds 40%. This wasting syndrome leads to nutritional deterioration and immune dysfunction and is directly responsible for at least 20% of cancer-related deaths. Previously, non-nanocrystal formulations of megestrol acetate had clear clinical limitations: effective absorption required concomitant intake of high-fat, high-calorie meals, onset of action was slow, and overall efficacy was limited. The advent of Megace® precisely addresses the unmet needs of patients with anorexia or swallowing difficulties, providing a scientifically sound solution for this underserved population.

In December 2025, Megace® was successfully included in the National Reimbursement Drug List (NRDL) of China (2025 Edition) for Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance, with official implementation beginning on January 1, 2026, significantly improving patient access to this innovative therapy.

Key Advantages: Nanocrystal Technology Driving Superior Efficacy and Convenience

The core competitiveness of Megace® lies in its nanocrystal technology, which reduces drug particle size by approximately 20,000-fold. This dramatically enhances drug solubility and bioavailability, delivering triple improvements in efficacy, onset speed, and ease of use—benefits well supported by clinical data.

In terms of efficacy, Megace® demonstrates significantly greater weight gain compared with traditional non-nanocrystal formulations. Clinical data show that after 12 weeks of treatment, patients achieved an average weight gain of up to 5.8 kg, approximately 2.3 times that of non-nanocrystal formulations. Some studies report weight recovery levels 1.5–2.1 times higher than conventional formulations. Regarding onset of action, the earliest time to significant weight recovery was shortened from 14 days to just 3 days, representing an 80% improvement in onset speed. This allows patients to rapidly experience improvements in appetite and body weight, strengthening confidence in treatment.

In patients undergoing radiotherapy for head and neck cancers, prophylactic use of Megace® effectively reduced weight loss: the treatment group experienced an average decrease of only 0.6 kg, compared with 3.2 kg in the control group, clearly demonstrating its nutritional protective benefits.

From a convenience perspective, Megace® eliminates the dietary restrictions associated with traditional formulations and achieves efficient absorption without the need for high-fat, high-calorie meals—an especially important advantage for patients already suffering from anorexia. Its oral liquid formulation is particularly suitable for patients with head and neck or upper gastrointestinal cancers who experience swallowing difficulties. The suspension can be swallowed directly or mixed with a small amount of warm water. With the included graduated dosing cup, accurate dose measurement is ensured, further improving convenience and adherence.

Additionally, the daily dose of Megace® is only 625 mg (5 mL), significantly lower than the 800 mg (equivalent to 5–20 tablets) typically required with conventional tablet formulations. This reduces pill burden and further enhances treatment compliance.

In terms of safety and standardization, Megace® also performs well. It has a favorable safety profile, with a lower incidence of adverse events compared with non-nanocrystal formulations. It is the only product in its class with explicit CACS indications and oral dosing specified in the prescribing information, minimizing the risk of misuse and simplifying clinical management. Moreover, nanocrystal technology ensures more stable absorption and reduces interpatient variability, resulting in consistent efficacy and improved treatment reliability.

Guideline Endorsement and Clinical Value: Safeguarding Nutrition to Support Comprehensive Care

Megestrol acetate, as a progestational agent, has well-established mechanisms for appetite stimulation, weight gain, and inflammation suppression. It is consistently recommended as a Class I standard therapy in both domestic and international guidelines. As an upgraded nanocrystal formulation, Megace® has received strong endorsement from authoritative guidelines. The Chinese Society of Clinical Oncology (CSCO) Guidelines for the Diagnosis and Treatment of Cancer Anorexia–Cachexia Syndrome (2025) list Megace® as a Level 1 recommendation (Class 1A evidence) and designate it as the preferred first-line treatment for CACS. In addition, the NCCN Palliative Care Guidelines recommend megestrol acetate for improving appetite and weight in patients with cancer.

From a clinical value perspective, Megace® not only improves appetite and body weight but also stabilizes nutritional status, enhances physical strength and immune function, and improves patients’ tolerance to primary treatments for cancer or AIDS. This enables patients to better complete their treatment courses, thereby improving quality of life and extending survival. Even in patients who previously responded poorly to conventional tablet formulations, Megace® has demonstrated significant efficacy, offering a new therapeutic option.

As a reimbursed medication under the national insurance system, Megace® primarily replaces non-nanocrystal formulations already listed in the reimbursement catalog. This reduces the financial burden on patients while aligning with the principle of “basic coverage.” Its standardized dosing design also supports rational use of medical insurance funds and efficient allocation of healthcare resources. Storage requirements are convenient: store below 25°C, keep out of reach of children, and once opened, the product may be stored in its original container and used for up to 30 days at temperatures below 25°C.

Conclusion

Megace® (Megestrol Acetate Oral Suspension), driven by advanced nanocrystal technology, overcomes the limitations of traditional cachexia treatments through precise indication positioning, robust clinical efficacy, and convenient administration. It has become a powerful nutritional support option for patients with cancer- or AIDS-related cachexia, particularly those with CACS. Inclusion in the national reimbursement list has further improved accessibility, enabling more patients facing nutritional challenges to receive effective, evidence-based treatment.

It should be emphasized that Megace® is a prescription medication and must be used strictly in accordance with medical guidance. Patients should not adjust the dose or discontinue treatment without authorization, and close monitoring with regular follow-up assessments is essential to ensure safe use. With continued clinical adoption, Megace® is expected to bring renewed hope to more patients with cachexia—helping them restore nutritional status, regain confidence, and move further along their journey against disease.