Study describes promising approach to treating cancer-related anorexia

Author: William G. Gilroy

Rudolph M. Navari

A new study by Rudolph M. Navari, director of the University of Notre Dame’s Walther Cancer Research Center, and Marie C. Brenner, a Notre Dame graduate who is a student at Loyola University Medical School in Chicago, describes how a novel combination of two drugs continues to show great promise in treating cancer-related anorexia (CRA).

Fifty percent of patients with a new cancer diagnosis and up to 70 percent of patients with advanced cancers may experience anorexia.

In previous studies, Navari and researchers working with him have shown that the drug olanzapine was highly effective in controlling chemotherapy’s most common side effects.

Olanzapine, which carries the brand name Zyprexa, has been used since the 1990s to treat schizophrenia and other psychoses. In early studies, Navari and his researchers found that when olanzapine was added to corticosteroids and other antiemetics historically used to treat chemotherapy-induced nausea and vomiting, there was essentially no nausea or vomiting in the 24-hour period following treatment. The drug also prevented nausea and vomiting during the week after chemotherapy if it was given daily for two to five days.

Use of the drug megestrol acetate (MA) has resulted in weight gain in some CRA patients, but has been less effective in improving appetite and quality of life.

The new study sought to determine the effectiveness of a combination of MA and olanzapine for treatment of CRA.

A group of 80 patients with advanced gastrointestinal or lung cancer were randomly selected to receive either MA alone, or a combination of olanzapine and MA. The patients were evaluated at four weeks and eight weeks and the results showed that 20 of the 39 patients receiving MA plus olanzapine had significant improvements in weight gain, appetite, nausea and quality of life measures.

Twenty-one of the 37 patients receiving MA alone experienced weight gain, but there was no significant change in appetite, nausea or quality of life measures, suggesting that the combination of olanzapine and MA appears to be an effective intervention for patients with CRA.

Navari, who also is director and assistant dean of the Indiana University School of Medicine South Bend, presented the paper’s findings at the annual meeting of the Multinational Association of Supportive Care in Cancer, held June 25 to 27 in Rome. The study was funded by the Walther Cancer Foundation and the Reich Family Endowment for the Care of the Whole Patient.

Navari said that the next step in the research is a national study in association with the Mayo Clinic.

Contact: Rudolph Navari, director, Walther Cancer Research Center, 574-631-3793,