Treatment of cancer-related anorexia with olanzapine and megestrol acetate: a randomized trial.
OBJECTIVE
The purpose of the study was to determine the effectiveness of megestrol acetate (MA) and olanzapine (OLN) for the treatment of cancer-related anorexia (CRA).


METHODS
Eighty adult patients with advanced gastrointestinal cancer or lung cancer (stages III and IV) with CRA (loss of appetite and greater than or equal to 5% loss of preillness stable weight) were randomized to receive daily MA or MA plus OLN for a period of 8 weeks. Patients were assessed weekly using the M.D. Anderson Symptom Inventory with specific measurement of weight, appetite, nausea, and quality of life (QOL) measures.


RESULTS
For the 37 patients receiving MA, 15 patients had a greater than or equal to 5% weight gain, 2 patients had an appetite improvement, 3 patients had an improvement in nausea, and 5 patients had an improvement in QOL at both 4 and 8 weeks. For the 39 patients receiving MA plus OLN, 33 patients had a greater than or equal to 5% weight gain, 25 patients had an appetite improvement, 21 patients had an improvement in nausea, and 23 patients had an improvement in QOL at both 4 and 8 weeks, and there was an improvement in general activity, mood, work, walking, and enjoyment at 8 weeks. There were no grade III or IV treatment-related toxicities in patients receiving MA or the combination of MA plus OLN.


CONCLUSIONS
The combination of MA and OLN appears to be an effective intervention for patients with CRA.
Navari
Rudolph M
RM
Department of Medicine, Indiana University School of Medicine South Bend, IN, USA. navari.1@nd.edu
Brenner
Marie C
MC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000188:drug therapy* / Q000209:etiology; D001066:Appetite / Q000187:drug effects; D019167:Appetite Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000008:administration & dosage / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D019290:Megestrol Acetate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009367:Neoplasm Staging; D000077152:Olanzapine; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use
D019167:Appetite Stimulants; D001569:Benzodiazepines; D019290:Megestrol Acetate; D000077152:Olanzapine; D017367:Selective Serotonin Reuptake Inhibitors