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Cancer Survivorship and Care / Oral Health in Cancer Treatment · Journal article
Cancers · September 11, 2026
Early or partial results. Treat as a signal, not a conclusion.
This retrospective real-world analysis of 45 cancer rehabilitation patients found no significant differences between olanzapine-treated and comparison groups on weight gain or body composition outcomes, contrary to controlled trial evidence cited in the 2023 ASCO recommendation. The study identified fatigue as a predictor of physical therapy goal completion but does not support the efficacy of olanzapine for appetite and weight gain in this cohort.
Retrospective cohort study. 45 patients with appetite concerns undergoing cancer-related outpatient rehabilitation; treatment groups well matched at baseline.. Intervention: Olanzapine (dose and duration not specified). Compared with: Comparison group (composition and care details not specified). n = 45.
No statistical differences between treatment groups on weight gain outcomes No significant between-group differences in body composition metrics Fatigue was a significant predictor of PT goal completion (p = 0.017)
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These negative findings suggest that olanzapine's efficacy for appetite stimulation and weight gain in advanced cancer cachexia may not generalize from controlled trial populations to real-world rehabilitation cohorts, warranting caution in application and further investigation before routine use.
Small retrospective cohort study with no significant between-group differences on the primary outcomes of weight gain and body composition, contradicting controlled trial evidence and providing limited support for olanzapine's efficacy in this population.
As stated by the source record.
Quoted from the source exactly as published.
These negative findings suggest that olanzapine's efficacy for appetite stimulation and weight gain in advanced cancer cachexia may not generalize from controlled trial populations to real-world rehabilitation cohorts, warranting caution in application and further investigation before routine use.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background/Objectives: Cachexia is a multifactorial muscle wasting syndrome driven by inflammation, causing increased catabolism and decreased food intake. Using appetite stimulation as part of multidisciplinary rehabilitation for cachexia is an emerging strategy. Olanzapine was originally developed as an atypical antipsychotic and has since emerged in rehabilitative strategies in patients with brain injury and chemotherapy-induced nausea. In 2023, the American Society of Clinical Oncology (ASCO) issued a rapid recommendation for the use of low-dose (2.5–5 mg) olanzapine to improve appetite and weight in adults with advanced cancer cachexia, based on novel evidence of increased appetite and weight gain. Methods: We retrospectively evaluated the impact of olanzapine on a real-world cohort of 45 patients with appetite concerns undergoing cancer-related rehabilitation. Patients were retrospectively evaluated for changes in body composition metrics and physical therapy (PT) related outcomes. Results: While treatment groups were well matched at baseline, there were no statistical differences between group outcomes, including weight gain, contrary to findings in other populations. However, fatigue was a significant predictor of PT goal completion across the cohort (p = 0.017), highlighting the need for future studies to investigate this relationship more deeply. Conclusions: These results indicate that the effects of olanzapine may vary between different clinical populations and suggest that further investigation into adjuvant therapies remains critical for optimizing care for cancer patients with anorexia.
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