ClinicalTrials.gg
RecruitingNCT05705492Updated Jul 16, 2026

Olanzapine for the Management of Cancer Associated Appetite Loss in Patients With Advanced Esophagogastric, Hepatopancreaticobiliary, Colorectal or Lung Cancer

A Phase 2 interventional study of Olanzapine and Placebo Administration in Advanced Malignant Solid Neoplasm, Advanced Biliary Tract Carcinoma and Advanced Esophageal Carcinoma, sponsored by OHSU Knight Cancer Institute. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-16.

Sponsored by OHSU Knight Cancer Institute · Phase 2, Interventional, and Supportive care

From the registry’s dates

  • Started Jul 2024; still recruiting 2 years 3 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
66
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This phase II trial tests how well olanzapine works in managing cancer cachexia in patients experiencing esophagogastric, hepatopancreaticobiliary, colorectal, or lung cancer that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced) or that has spread from where it first started (primary site) to other places in the body (metastatic) -associated appetite loss while receiving non-curative cancer therapy. Loss of appetite ("anorexia") in the setting of cancer is a key feature of "cachexia," a syndrome associated with loss of weight and muscle as well as weakness and fatigue. Olanzapine is a drug that targets key neurotransmitters (a type of molecule in the central nervous system that transmits messages to the rest of the body) that may stimulate appetite, restore caloric intake, minimize weight loss, and improve quality of life (QOL).

Read the detailed description

PRIMARY OBJECTIVE:

I. To assess the impact of olanzapine 2.5 mg versus (vs) placebo on the proportion of patients with locally advanced or metastatic EG, HPB, or lung cancers receiving first-line systemic standard-of-care (SOC) therapy with >5% weight gain over 12 weeks. (Part A)

SECONDARY OBJECTIVE:

I. To evaluate the impact of olanzapine 2.5 mg and placebo vs olanzapine 5 mg on the proportion of patients with >5% weight gain over 12 weeks. (Part A) II. To evaluate the impact of olanzapine 2.5 mg vs olanzapine 5 mg vs placebo on additional cancer cachexia-associated endpoints over 12 weeks (anorexia, nutritional status, physical function, patient-reported symptoms, QOL, safety and toxicity, and healthcare utilization) over 12 weeks. (Part A)

OUTLINE:

PART A: Patients are randomized to 1 of 3 arms. All three arms have an optional baseline computed tomography (CT) scan (timed with standard-of-care imaging) at baseline and optional monthly blood sample collections.

ARM I: Patients receive a lower (2.5 mg) dose of olanzapine orally (PO) nightly for 12 weeks in the absence of unacceptable toxicity. Patients may choose to enroll in an additional 12 weeks of treatment (Part B). Patients may choose to participate to undergo CT scan and collection of blood samples on study.

ARM II: Patients receive a higher (5 mg) dose of olanzapine PO nightly for 12 weeks in the absence of unacceptable toxicity. Patients may choose to enroll in an additional 12 weeks of treatment. Patients may choose to participate to undergo CT scan and collection of blood samples on study.

ARM III: Patients receive placebo PO nightly for 12 weeks in the absence of unacceptable toxicity. Patients may choose to enroll in an additional 12 weeks of treatment. Patients may choose to participate to undergo CT scan and collection of blood samples on study.

PART B: All patients receive a lower (2.5mg) dose of olanzapine PO nightly for 12 additional weeks in the absence of unacceptable toxicity. Patients may choose to participate in additional blood sample collections.

After completion of study treatment, patients are followed up at 1 week.

02

Conditions studied

  • Advanced Malignant Solid Neoplasm
  • Advanced Biliary Tract Carcinoma
  • Advanced Esophageal Carcinoma
  • Metastatic Esophageal Carcinoma
  • Locally Advanced Colorectal Carcinoma
  • Locally Advanced Esophageal Carcinoma
  • Locally Advanced Gastric Carcinoma
  • Metastatic Colorectal Carcinoma (mCRC)
  • Advanced Lung Carcinoma
  • Locally Advanced Hepatocellular Carcinoma

Keywords

  • cancer
  • cachexia
  • weight loss
  • loss of appetite
03

In context

Esophageal Neoplasms

1,873 studies on the registry are indexed under Esophageal Neoplasms; 501 are open to participants now.

This study's planned enrollment of 66 is above the median of 58 across 1,347 interventional studies indexed under Esophageal Neoplasms.

Browse Esophageal Neoplasms studies →

Lead sponsor

OHSU Knight Cancer Institute is the lead sponsor of 243 studies on the registry; 44 are open to participants now.

Of its 27 completed or terminated interventional studies of FDA-regulated products, 15 (56%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Willingness to provide written
  • Individuals >= 18 years of age
  • confirmed advanced local or esophogastric, hepatopancreaticobiliary, colorectal, or lung cancer diagnosis within 12 weeks of screening
  • Patients with weight loss as defined by international consensus criteria (documented or patient-reported):

    • ≥ 5% weight loss over the past 6 months
    • ≥ 2% weight loss with (BMI) \<20 kg/m\^2 or sarcopenia
  • Planned or ongoing palliative antineoplastic therapy (cytotoxic chemotherapy, targeted therapy, immunotherapy, combinations) with or without radiation therapy and have not started the second cycle of first-line palliative antineoplastic therapy. Patients may have received antineoplastic therapy at least 6 months prior to screening
  • Able to ambulate independently with or without assistive devices (e.g., cane, walker)
  • In the case of , the individual must be asymptomatic or previously treated with a full cycle of therapy with recovery from any acute effects of radiation therapy or surgery before screening. Such individuals must have discontinued treatment and be neurologically stable for at least 4 weeks before screening
  • (ECOG) performance status of 0-2
  • Able and willing to discontinue the use of any drug or over-the-counter (OTC) product that may interact with the study drug (within a period sufficient for wash-out per the principal investigators [PI's] discretion) and thereafter while on the study
  • Willingness to comply with restrictions on chest/breastfeeding
  • Individuals capable of childbearing and contributing viable sperm must be willing to comply with requirements and not donate ova or sperm while on the study and for 1 month after that
  • A negative pregnancy test at baseline (BL) must be obtained for individuals capable of childbearing

Exclusion criteria

Exclusion Criteria:

  • Plan for, or history of (within 30 days of enrollment), the use of an antipsychotic drug, including, but not limited to, risperidone, quetiapine, clozapine, phenothiazine, or butyrophenone. This limitation does not include prochlorperazine and other phenothiazines as antiemetic therapy. The use of antipsychotics concurrent with protocol therapy will not be allowed
  • Current use of medications or supplements with the goal of enhancing appetite within ≥14 days, including:

    • megestrol acetate
    • cannabinoids (including, but not limited to dronabinol, medical cannabis, over the counter [OTC] cannabinoid products), and/or
    • (defined as ≥ 5mg of prednisone [or equivalent per day]), except for standard-of-care chemotherapy-induced nausea and vomiting prophylaxis
  • Known history of poorly controlled diabetes, defined as fasting morning blood sugars ≥300 mg/dL or recent A1≥ 8. Individuals with diabetes will undergo (HbA1c) blood testing if they do not have HbA1c results 12 weeks prior to enrollment
  • Inadequate organ function, which may include, but is not limited to, the following laboratory results within 28 days before signing consent:

    • Total ≥5x (ULN), (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SPGT]) ≥5X ULN (unless the participant has documented Gilbert's syndrome, hepatocellular carcinoma, or hepatic )
    • Primary investigator (PI) discretion will determine continued eligibility after randomization occurs in the event the liver function test results are above the proposed ULN
    • Renal disease requiring dialysis or calculated (GFR) ≤ 30 mL/minute/1.73 m\^2 as calculated by the modification of diet in renal disease (MDRD) equation
  • Tube feeding or parenteral nutrition at the time of screening
  • Any condition that may negatively impact oral absorption of the study drug (including, but not limited to dysphagia, mucositis, gastrectomy, colitis, bowel obstruction, high output ileostomy) or any plan to undergo an intervention that will render such a condition
  • Recurrent ascites unresponsive to medical interventions and requires therapeutic paracentesis
  • Uncontrolled symptoms at randomization make the individual unsuitable for the study in the judgment of the PI. If uncontrolled symptoms can be effectively palliated for ≥1 week prior, enrollment may be considered at the discretion of the PI
  • Uncontrolled infection, including coronavirus disease 2019 (COVID-19), at time of randomization. Individuals with the uncontrolled infection will not be eligible as the symptomology of infection may obscure the outcomes of this study
  • Other medical or psychiatric condition, including recent (within 1 year) or active suicidal ideation/behavior or laboratory abnormality, may increase the risk of study participation or, in the PI's judgment, makes the participant inappropriate for the study
Terms in these criteria, in plain language(16)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

05

Study design

Phase
Phase 2
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
66 participants (estimated)

Study arms

  • Experimental
    Arm I (olanzapine, optional biospecimen collection)

    Patients receive a lower (2.5mg) dose of olanzapine orally (PO) nightly for 12 weeks in the absence of unacceptable toxicity. Patients may choose to enroll in an additional 12 weeks of treatment. Patients can choose to undergo computed tomography (CT) scan at baseline and monthly blood sample collections on study.

    Drug: Olanzapine · Other: Questionnaire Administration

  • Experimental
    Arm II

    Patients receive a higher dose (5 mg) of olanzapine PO nightly for 12 weeks in the absence of unacceptable toxicity. Patients may choose to enroll in an additional 12 weeks of treatment. Patients undergo an optional baseline CT scan and collections of monthly blood samples on study.

    Drug: Olanzapine · Other: Questionnaire Administration

  • Placebo comparator
    Arm III

    ARM III: Patients receive placebo PO nightly for 12 weeks in the absence of unacceptable toxicity. Patients may choose to enroll in an additional 12 weeks of treatment. Patients undergo CT scan and monthly collection of blood samples on study.

    Drug: Placebo Administration · Other: Questionnaire Administration

Interventions

  • Given PO

    Also known as: LY 170053, Zyprexa, Zyprexa Zydis

  • DrugPlacebo Administration

    Given PO

  • OtherQuestionnaire Administration

    Ancillary studies

06

What researchers measure

Primary outcomes

  1. Proportion of patients exhibiting weight gain greater 5%

    \>5% weight gain comparing olanzapine 2.5mg (Arm I) vs. placebo (Arm III)

    Time frame: Baseline to 12 weeks from baseline

Secondary outcomes

  1. Change in Weight

    \>5% weight gain comparing olanzapine 2.5 mg (Arm I) vs. olanzapine 5mg (Arm II) \>5% weight gain comparing olanzapine 5 mg (Arm II) vs. placebo (Arm III)

    Time frame: Baseline to 12 weeks from baseline

  2. Anorexia

    Patient reported anorexia comparing olanzapine 2.5 mg (Arm 1) vs. olanzapine 5 mg (Arm 2) vs. placebo (Arm 3) Anorexia will be measured using the Functional Assessment of Anorexia-Cachexia Therapy (FAACT), a 12-item subscale of patients' perceptions of appetite (maximum score of 48, higher scores indicate less anorexia). A FAACT score ≤ 37 indicates anorexia.

    Time frame: At 12 weeks from baseline]

  3. Appetite

    Change in appetite will be measured using the Visual Analog Scale for appetite (VAS), a 10-point scale with a higher score indicating a better appetite. A ≥3-point improvement in appetite at the end of the 12-week placebo-controlled Part A as compared to baseline in each arm will be considered an improvement in appetite.

    Time frame: Baseline up to 12 weeks from baseline

  4. Nutrition

    Nutritional Status will be measured using the Patient- Generated Subjective Assessment Short Form (PG-SGA-SF); scored on a scale of 0-36 with a higher score indicating worse malnutrition.

    Time frame: At baseline and at 4, 8, 12 weeks from baseline

  5. Physical Function

    Eastern Cooperative Oncology Group (ECOG) Performance Status is a clinician's assessment of physical function rated 0 to 5 with a lower score indicating better performance.

    Time frame: At baseline and at 4, 8, and12 weeks from baseline

  6. Physical Function

    Karnofsky Performance Scale (KPS) is a clinician assessed score (0-100) to evaluate physical function and ability to carry out daily activities. A higher score indicates better performance. \[Time Frame: At baseline and at 4, 8, 12 weeks from baseline\]

    Time frame: At baseline and at 4, 8, and12 weeks from baseline

  7. Physical Function

    Tthe Short Physical Performance Battery (SPPB) is a physical function assessment consisting of 3 timed measures and scored 0 to 12 with a higher score indicating better performance.

    Time frame: At baseline and at 4, 8, and12 weeks from baseline

  8. Patient Reported Quality of Life

    Patient reported quality of life will be measured using the Functional Assessment of Cancer Therapy - General (FACT-G,) consisting of four domains (physical, social, emotional, and functional) of well-being with scores ranging from 0 to 108 with higher scores indicating better QOL.

    Time frame: Baseline to 12 weeks from baseline

  9. Patient-reported impression of change

    Patient Global Impression of Change (PGI-C) is a 7-point scale depicting a patient's rating of overall improvement in appetite and fatigue with a higher score indicating more improvement .

    Time frame: At 12 weeks from baseline

  10. Patient Reported Symptoms

    Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) will be used to capture symptoms associated with cancer cachexia and/or its treatment. Each response is scored from 0-4 with a higher score indicating more severity.

    Time frame: At 4, 8, and 12 weeks from baseline

  11. Incidence of adverse events

    National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.

    Time frame: At 4, 8, and 12 weeks from baseline

  12. Proportion of patients with ≥1 unplanned hospitalization

    Calculation and analysis of patients who have 1 or more unplanned hospitalization.

    Time frame: At baseline and at 4, 8, and 12 weeks from baseline

  13. Proportion of patients with ≥1 emergency department visit

    Health care utilization including emergency department visits, hospital admissions.

    Time frame: At baseline and at 4, 8, and 12 weeks from baseline

  14. Proportion of patients with ≥1 unplanned hospitalization

    Number of unplanned hospitalizations

    Time frame: From baseline to 12 weeks

07

Study locations

1 of 1 sites recruiting
  • OHSU Knight Cancer Institute
    Portland, Oregon 97239, United States
    Recruiting
    • Eric Roeland, M.D., FAAHPM, FASCO · Contactroeland@ohsu.edu · 503-494-8534
    • Eric Roeland, M.D., FAAHPM, FASCO · Principal investigator
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jul 2024 (actual). Primary completion is estimated for Jun 2027, 35 months after the start.

Of 174 non-industry phase 2 interventional studies under Esophageal Neoplasms, half reached primary completion within 55 months of starting (the median), counting those still running; a quarter within 33 and three quarters within 85. This study's planned 35 months is below that.

Counting every sponsor, half of 198 studies reached it within 52 months; a quarter within 33 and three quarters within 78.

How these figures are worked out, and which studies are left out of them.

Registered
Jan 6, 2023
First posted
Jan 30, 2023
StartActual
Jul 17, 2024
Primary completionEst.
Jun 30, 2027
CompletionEst.
Jun 30, 2027
Last update
Jul 16, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 16, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05705492
Responsible party
Eric Roeland, M.D.,FASCO, FAAHPM (Principal Investigator, OHSU Knight Cancer Institute) — Principal investigator
First posted
Jan 30, 2023
Start date
Jul 17, 2024
Primary completion
Jun 30, 2027 (estimated)
Completion
Jun 30, 2027 (estimated)
Last update
Jul 16, 2026

Study contacts

Eric Roeland, M.D., FAAHPM, FASCO
principal investigator · OHSU Knight Cancer Institute

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Olanzapine

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