Nausea and loss of appetite can be difficult to manage during cancer treatment and often limit tolerance of optimal therapy. In this randomized, double-blind, placebo controlled trial, 112 patients newly diagnosed, advanced lung, gastric, and hepatobiliary cancer were randomized to receive either olanzapine or placebo along with standard systemic therapy. Olanzapine was given at a dose of 2.5mg for 12 weeks. Olanzapine significantly increased the proportion of patients who had >5% weight gain during treatment from just 9% to 60%. Far more patients also reported increased appetite (48% v 13%) as well as better quality of life and less toxicity from systemic therapy. | Sandhya, J Clin Oncol 2023