{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:46:07Z","timestamp":1790948767263,"version":"4.1.0"},"reference-count":40,"publisher":"Harborside Press, LLC","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"Background:<\/jats:bold> Pharmacologic options for managing anorexia in cancer cachexia are limited. This trial aimed to evaluate the efficacy of olanzapine in alleviating anorexia in patients with incurable cancer and cachexia. Methods:<\/jats:bold> This double-blind, placebo-controlled, randomized trial included adult patients with incurable cancer and cachexia, scoring \u22654 on the Edmonton Symptom Assessment Scale (ESAS) anorexia item (ESAS-Anorexia) and <4 on the ESAS nausea item (ESAS-Nausea). A total of 164 patients were randomized in a 1:1 ratio to receive either placebo (n=82) or olanzapine 5 mg daily (n=82) for 4 weeks. The primary outcome was the change in ESAS-Anorexia score after 1 week. Secondary outcomes included changes in anorexia and quality of life scores, body weight, and handgrip strength after 4 weeks. Results:<\/jats:bold> In the complete case analysis of the primary outcome (n=159; 97%), median [IQR] reduction in ESAS-Anorexia score after 1 week was significantly greater in the olanzapine group (\u22122 [\u22123 to 0] vs \u22121 [\u22122 to 0]; P<\/jats:italic>=.003). The significance continued at 2 weeks (\u22122 [\u22124 to \u22121] vs \u22121 [\u22122 to 0]; P<\/jats:italic>=.039). After 4 weeks, significantly more patients in the olanzapine group experienced >5% weight gain (14% vs 0%; P<\/jats:italic>=.008), and the mean [SD] improvement in Functional Assessment of Anorexia\/Cachexia Therapy \u2013 Anorexia\/Cachexia Subscale score was higher (+2.7 [7.4] vs \u22120.04 [7]; P<\/jats:italic>=.043). The mean [SD] decline in handgrip strength was greater with olanzapine and was significant in per-protocol analysis (\u22122.8 [4.9] kg vs \u22120.3 [4.1] kg; P<\/jats:italic>=.027). Anxiety, insomnia, and nausea (P<\/jats:italic>=.016, P<\/jats:italic>=.034, and P<\/jats:italic>=.039, respectively) were significantly less frequent with olanzapine, whereas grade \u22653 anemia and leukopenia were more frequent (P<\/jats:italic>=.018 and P<\/jats:italic>=.041, respectively). Conclusions:<\/jats:bold> A short course of olanzapine 5 mg daily significantly reduces anorexia in patients with incurable cancer and cachexia. Further studies are needed to evaluate its long-term safety and efficacy in cancer cachexia.<\/jats:p>","DOI":"10.6004\/jnccn.2025.7033","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:07:19Z","timestamp":1753884439000},"page":"385-392","source":"Crossref","is-referenced-by-count":10,"title":["Olanzapine for Anorexia in Patients With Incurable Cancer and Cachexia (OlAnCa): A Double-Blind, Placebo-Controlled, Randomized Clinical Trial"],"prefix":"10.6004","volume":"23","author":[{"given":"Nada O.","family":"Othman","sequence":"first","affiliation":[{"name":"Palliative Medicine Unit, Department of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesham H.","family":"Abdel-Aal","sequence":"additional","affiliation":[{"name":"Departments of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wessam A.","family":"Elsherief","sequence":"additional","affiliation":[{"name":"Departments of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina E.","family":"Farag","sequence":"additional","affiliation":[{"name":"Departments of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine N.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Departments of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samy A.","family":"Alsirafy","sequence":"additional","affiliation":[{"name":"Palliative Medicine Unit, Department of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"Lancet Oncol","first-page":"489","article-title":"Definition and classification of cancer cachexia: an international consensus","volume":"12","author":"Fearon K","year":"2011","unstructured":"Fearon K, Strasser F, Anker SD, Definition and classification of cancer cachexia: an international consensus. 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