Loading
A double-blind trial at Tata Memorial in India randomised 124 patients starting chemotherapy to 2.5 mg of olanzapine, a decades-old tablet costing a few cents a day, or placebo. Six in ten gained more than 5% of their weight against one in ten on placebo, and ASCO listed it in its 2024 cachexia guideline; it was small and single-centre.
124 patients were randomised, double-blind. The primary endpoint, weight gain over 5% at 12 weeks, was achieved by 60% of patients on olanzapine vs 9% on placebo; appetite improved (visual analogue scale) in 43% vs 13%, and quality of life and chemotherapy toxicity scores favoured olanzapine. Adverse events were minimal at this dose (no excess sedation or metabolic effects over 12 weeks). The trial led ASCO to list low-dose olanzapine as an option in its 2024 cachexia guideline update. It is small, single-centre and short, and did not measure lean mass or survival; a multi-country replication is the obvious next step. Its significance is access: olanzapine is on the WHO essential medicines list and costs a few cents a day.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
124 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Weight gain greater than 5% at 12 weeksprimary | Olanzapine 2.5 mg | 63 | 60% | - | <0.001 | link |
| Placebo | 61 | 9% |
Shares Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine, Cancer cachexia, Cachexia, toxicity and the limits of the patient, Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards.
Shares Blinding (double-blind, open-label, placebo-controlled), Systematic drug repurposing, Placebo, Tata Memorial Centre.
Shares Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine, Cachexia, toxicity and the limits of the patient, Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards, Gastric & gastro-oesophageal junction cancer.
Shares Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine, Cachexia, toxicity and the limits of the patient, Most of the world has almost no cancer care, Gastric & gastro-oesophageal junction cancer.
Shares Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine, Cancer cachexia, Cachexia, toxicity and the limits of the patient, Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards.
Shares Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine, Cancer cachexia, Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment.
Shares Nutrition impact symptoms, Cancer cachexia, Cachexia, toxicity and the limits of the patient, Gastric & gastro-oesophageal junction cancer.
Shares Cancer cachexia, Cachexia, toxicity and the limits of the patient, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Pancreatic ductal adenocarcinoma.