In an Indian single-center study reported in the Journal of Clinical Oncology, Sandhya et al found that olanzapine was associated with weight gain and improved appetite vs placebo in patients receiving chemotherapy for newly diagnosed locally advanced or metastatic gastric, hepatopancreaticobiliary, or lung cancers.
Study Details
In the double-blind trial, 112 evaluable patients being treated at Jawaharlal Institute of Postgraduate Medical Education and Research were randomly assigned between November 2020 and June 2022 to receive olanzapine at 2.5 mg (n =58) or placebo (n = 54) once a day for 12 weeks together with chemotherapy. Both groups received standard nutritional assessment and dietary advice. Overall, 55% of patients had gastric, 35% had lung, and 10% had hepatopancreaticobiliary cancer; 84% of patients had stage IV disease.
The primary outcome measures were the proportion of patients with weight gain of more than 5% and improvement in appetite as assessed by the visual analog scale (VAS) and the Functional Assessment of Chronic Illness Therapy system of Quality-of-Life questionnaires Anorexia Cachexia subscale (FAACT ACS) at 12 weeks.
Key Findings
At 12 weeks, weight gain > 5% was observed in 35 (60%) of 58 patients in the olanzapine group vs 5 (9%) of 54 in the placebo group (P < .001).
Improvement in appetite on VAS assessment occurred in 25 patients (43%) in the olanzapine group vs 7 (13%) in the placebo group (P < .001). Improvement in appetite on FAACT ACS score was observed in 13 (22%) vs 2 (4%) patients (P = .004).
Nutrition scores improved in 43% vs 9% of patients (P < .0001). Improvement in quality of life on the Cancer Institute Quality of Life tool occurred in 70% vs 50% of patients (P = .003). The proportions of patients with grade ≥ 3 adverse events during chemotherapy were 12% vs 37% (P = .002).
Adverse events considered related to study treatment occurred in 13 patients (23%) in the olanzapine group (one grade 3 event) and 8 (15%) in the placebo group (two grade 3 events).
The investigators concluded, “Low-dose, daily olanzapine is a simple, inexpensive, well-tolerated intervention that significantly improves appetite and weight gain in newly diagnosed patients on chemotherapy.”
Prasanth Ganesan, MD, DM, of the Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by an intramural grant from Jawaharlal Institute of Postgraduate Medical Education and Research. For full disclosures of the study authors, visit ascopubs.org.
