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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04939090
Other study ID # A222004
Secondary ID NCI-2021-03303UG
Status Recruiting
Phase Phase 3
First received
Last updated
Start date January 3, 2022
Est. completion date December 2026

Study information

Verified date May 2024
Source Alliance for Clinical Trials in Oncology
Contact Aminah Jatoi, MD
Phone 507-266-9160
Email Jatoi.aminah@mayo.edu
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This phase III trial compares the effects of olanzapine versus megestrol acetate in treating loss of appetite in patients with cancer that has spread to other places in the body (advanced). Olanzapine may stimulate and increase appetite. This study aims to find out if olanzapine is better than the usual approach (megestrol acetate) for stimulating appetite and preventing weight loss.


Description:

The primary and secondary objectives of the study: PRIMARY OBJECTIVE: I. To determine whether olanzapine leads to greater appetite improvement from baseline in cancer patients suffering from anorexia compared to megestrol acetate using the 0-10 numerical rating scale (NRS). SECONDARY OBJECTIVES: I. To determine whether olanzapine leads to a greater proportion of patients who report a 5% or greater weight gain from baseline compared to megestrol acetate. II. To compare change in cachexia/anorexia symptoms with olanzapine compared to megestrol acetate using the Functional Assessment of Anorexia/Cachexia Treatment (FAACT)-Anorexia/Cachexia Subscale (A/CS) instrument. OUTLINE: Patient are randomized to 1 of 2 arms. ARM I: Patients receive olanzapine orally (PO) once daily (QD) for up to 4 weeks in the absence of consent withdrawal or unacceptable toxicity. ARM II: Patients receive megestrol acetate PO QD for up to 4 weeks in the absence of consent withdrawal or unacceptable toxicity.


Recruitment information / eligibility

Status Recruiting
Enrollment 360
Est. completion date December 2026
Est. primary completion date May 1, 2026
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Women and men of reproductive potential should agree to use an appropriate method of birth control throughout their participation in this study due to the teratogenic potential of the therapy utilized in this trial. Appropriate methods of birth control include abstinence, oral contraceptives, implantable hormonal contraceptives or double barrier method (diaphragm plus condom) - Diagnosis of advanced cancer - Patient-reported 2-month weight loss of at least 5 pounds (2.3 kilograms) and/or physician-estimated caloric intake of less than 20 calories/kilogram of body weight per day - The patient must perceive loss of appetite and/or weight as a problem; and have an appetite score of 4 or worse on the "Please rate your appetiteā€¦." question that requires a patient response on a 0-10 numeric rating scale - Not receiving ongoing tube feedings or parenteral nutrition at the time of registration - Not currently using systemic adrenal steroids (with the exception of short-term dexamethasone within 3 days of chemotherapy for control of chemotherapy side effects) - No use of androgens, progesterone analogs, or other appetite stimulants within the past month - Patient should not have poorly controlled hypertension or congestive heart failure at registration - Patient should not have an obstruction of the alimentary canal, malabsorption, or intractable vomiting (defined as vomiting more than 3 times per day over the preceding week) - Not currently using olanzapine for another medical condition or had previously used olanzapine for chronic nausea or for any pre-existing psychotic disorder - Patient should not have had a previous blood clot at any time in the past - No history of poorly controlled diabetes - No symptomatic leptomeningeal disease or known brain metastases as these patients may have difficulty taking oral medications - No history of hypersensitivity to olanzapine or megestrol acetate - No COVID-19 infection in the past that, in the opinion of the treating physician, had left patients with compromised taste, which has not resolved at the time of registration - Not pregnant and not nursing, because this study involves an investigational agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown. Therefore, for women of childbearing potential only, a negative urine or serum pregnancy test done =< 14 days prior to registration is required - Age >= 18 years - Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2 - Estimated life expectancy of 3 months or longer - Serum creatinine =< 2.0 mg/dL - Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) =< 3 x upper limit of normal (ULN) - Fasting glucose < 140 mg/dL - Granulocytes > 1000/hpf - No treatment with another antipsychotic agent, such as risperidone, quetiapine, clozapine, butyrophenone within 30 days of enrollment - In order to complete the mandatory patient-completed measures, participants must be able to speak and/or read English or Spanish. Sites seeking to enroll Spanish-speaking patients should have access to Spanish speaking staff on site or through the use of a translation service to be able to conduct the informed consent discussion in Spanish, and to conduct the weekly phone calls Exclusion Criteria: - Psychiatric illness which would prevent the patient from giving informed consent - Medical condition such as uncontrolled infection (including human immunodeficiency virus [HIV]), uncontrolled diabetes mellitus or cardiac disease which, in the opinion of the treating physician, would make this protocol unreasonably hazardous for the patient - Patients who cannot swallow oral formulations of the agents - Patients with impaired decision-making capacity (such as with a diagnosis of dementia or memory loss) are not eligible for this study - No presence of a hormone-sensitive tumor, such as breast, endometrial, or prostate cancer (this exclusion criterion is intended to circumvent any confounding antineoplastic effects of megestrol acetate)

Study Design


Related Conditions & MeSH terms

  • Advanced Malignant Solid Neoplasm
  • Anorexia
  • Hematopoietic and Lymphoid Cell Neoplasm
  • Neoplasms

Intervention

Drug:
Olanzapine
Given PO
Megestrol Acetate
Given PO
Other:
Questionnaire Administration
Ancillary studies

Locations

Country Name City State
United States Hawaii Cancer Care - Westridge 'Aiea Hawaii
United States Pali Momi Medical Center 'Aiea Hawaii
United States Mayo Clinic Health System in Albert Lea Albert Lea Minnesota
United States University of New Mexico Cancer Center Albuquerque New Mexico
United States Mary Greeley Medical Center Ames Iowa
United States McFarland Clinic - Ames Ames Iowa
United States Trinity Health Saint Joseph Mercy Hospital Ann Arbor Ann Arbor Michigan
United States ThedaCare Regional Cancer Center Appleton Wisconsin
United States Duluth Clinic Ashland Ashland Wisconsin
United States Piedmont Hospital Atlanta Georgia
United States Rocky Mountain Cancer Centers-Aurora Aurora Colorado
United States Rush - Copley Medical Center Aurora Illinois
United States Baptist Hospitals of Southeast Texas Cancer Center Beaumont Texas
United States UM Upper Chesapeake Medical Center Bel Air Maryland
United States Sanford Joe Lueken Cancer Center Bemidji Minnesota
United States ThedaCare Cancer Care - Berlin Berlin Wisconsin
United States University of Iowa Healthcare Cancer Services Quad Cities Bettendorf Iowa
United States Billings Clinic Cancer Center Billings Montana
United States Sanford Bismarck Medical Center Bismarck North Dakota
United States Illinois CancerCare-Bloomington Bloomington Illinois
United States Prisma Health Cancer Institute - Spartanburg Boiling Springs South Carolina
United States McFarland Clinic - Boone Boone Iowa
United States Tufts Medical Center Boston Massachusetts
United States Rocky Mountain Cancer Centers-Boulder Boulder Colorado
United States Essentia Health Saint Joseph's Medical Center Brainerd Minnesota
United States Trinity Health IHA Medical Group Hematology Oncology - Brighton Brighton Michigan
United States Trinity Health Medical Center - Brighton Brighton Michigan
United States James J Peters VA Medical Center Bronx New York
United States University of Vermont Medical Center Burlington Vermont
United States Illinois CancerCare-Canton Canton Illinois
United States Trinity Health IHA Medical Group Hematology Oncology - Canton Canton Michigan
United States Trinity Health Medical Center - Canton Canton Michigan
United States Saint Francis Medical Center Cape Girardeau Missouri
United States Illinois CancerCare-Carthage Carthage Illinois
United States Oncology Associates at Mercy Medical Center Cedar Rapids Iowa
United States Rocky Mountain Cancer Centers - Centennial Centennial Colorado
United States Centralia Oncology Clinic Centralia Illinois
United States Atrium Health Pineville/LCI-Pineville Charlotte North Carolina
United States Atrium Health University City/LCI-University Charlotte North Carolina
United States Carolinas Medical Center/Levine Cancer Institute Charlotte North Carolina
United States Saint Joseph Mercy Chelsea Chelsea Michigan
United States Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital Chelsea Michigan
United States Saint Luke's Hospital Chesterfield Missouri
United States Mount Sinai Hospital Medical Center Chicago Illinois
United States Northwestern University Chicago Illinois
United States Morton Plant Hospital Clearwater Florida
United States Southeastern Medical Oncology Center-Clinton Clinton North Carolina
United States Baptist Memorial Hospital and Cancer Center-Collierville Collierville Tennessee
United States Baptist Memorial Hospital and Cancer Center-Golden Triangle Columbus Mississippi
United States Atrium Health Cabarrus/LCI-Concord Concord North Carolina
United States Mercy Hospital Coon Rapids Minnesota
United States Northwest Cancer Center - Main Campus Crown Point Indiana
United States UT Southwestern Simmons Cancer Center - RedBird Dallas Texas
United States UT Southwestern/Simmons Cancer Center-Dallas Dallas Texas
United States Carle at The Riverfront Danville Illinois
United States Geisinger Medical Center Danville Pennsylvania
United States Cancer Care Specialists of Illinois - Decatur Decatur Illinois
United States Essentia Health - Deer River Clinic Deer River Minnesota
United States Northwestern Medicine Cancer Center Kishwaukee DeKalb Illinois
United States Rocky Mountain Cancer Centers-Midtown Denver Colorado
United States Rocky Mountain Cancer Centers-Rose Denver Colorado
United States Iowa Methodist Medical Center Des Moines Iowa
United States Mercy Medical Center - Des Moines Des Moines Iowa
United States Mission Cancer and Blood - Des Moines Des Moines Iowa
United States Ascension Saint John Hospital Detroit Michigan
United States Essentia Health Saint Mary's - Detroit Lakes Clinic Detroit Lakes Minnesota
United States Illinois CancerCare-Dixon Dixon Illinois
United States Epic Care-Dublin Dublin California
United States Essentia Health Cancer Center Duluth Minnesota
United States Saint Luke's Hospital of Duluth Duluth Minnesota
United States Northwest Oncology LLC Dyer Indiana
United States Prisma Health Cancer Institute - Easley Easley South Carolina
United States Great Lakes Cancer Management Specialists-Doctors Park East China Township Michigan
United States Mayo Clinic Health System-Eau Claire Clinic Eau Claire Wisconsin
United States Fairview Southdale Hospital Edina Minnesota
United States Crossroads Cancer Center Effingham Illinois
United States Epic Care Partners in Cancer Care Emeryville California
United States Mountain Blue Cancer Care Center - Swedish Englewood Colorado
United States Rocky Mountain Cancer Centers - Swedish Englewood Colorado
United States Illinois CancerCare-Eureka Eureka Illinois
United States Exeter Hospital Exeter New Hampshire
United States Essentia Health Cancer Center-South University Clinic Fargo North Dakota
United States Sanford Broadway Medical Center Fargo North Dakota
United States Sanford Roger Maris Cancer Center Fargo North Dakota
United States Parkland Health Center - Farmington Farmington Missouri
United States Piedmont Fayette Hospital Fayetteville Georgia
United States Genesee Cancer and Blood Disease Treatment Center Flint Michigan
United States Genesee Hematology Oncology PC Flint Michigan
United States Genesys Hurley Cancer Institute Flint Michigan
United States Levine Cancer Institute - Rutherford Forest City North Carolina
United States McFarland Clinic - Trinity Cancer Center Fort Dodge Iowa
United States Regional Cancer Center-Lee Memorial Health System Fort Myers Florida
United States Tarrant County Hospital District/JPS Health Network Fort Worth Texas
United States UT Southwestern/Simmons Cancer Center-Fort Worth Fort Worth Texas
United States Essentia Health - Fosston Fosston Minnesota
United States Beebe South Coastal Health Campus Frankford Delaware
United States Illinois CancerCare-Galesburg Galesburg Illinois
United States CaroMont Regional Medical Center Gastonia North Carolina
United States Levine Cancer Institute-Gaston Gastonia North Carolina
United States Northwestern Medicine Cancer Center Delnor Geneva Illinois
United States Tidelands Georgetown Memorial Hospital Georgetown South Carolina
United States Arizona Center for Cancer Care - Gilbert Gilbert Arizona
United States Glens Falls Hospital Glens Falls New York
United States Northwestern Medicine Glenview Outpatient Center Glenview Illinois
United States Southeastern Medical Oncology Center-Goldsboro Goldsboro North Carolina
United States Altru Cancer Center Grand Forks North Dakota
United States Grand Valley Oncology Grand Junction Colorado
United States Northwestern Medicine Grayslake Outpatient Center Grayslake Illinois
United States Benefis Sletten Cancer Institute Great Falls Montana
United States Saint Vincent Hospital Cancer Center at Saint Mary's Green Bay Wisconsin
United States Saint Vincent Hospital Cancer Center Green Bay Green Bay Wisconsin
United States Prisma Health Cancer Institute - Butternut Greenville South Carolina
United States Prisma Health Cancer Institute - Eastside Greenville South Carolina
United States Prisma Health Cancer Institute - Faris Greenville South Carolina
United States Prisma Health Greenville Memorial Hospital Greenville South Carolina
United States Prisma Health Cancer Institute - Greer Greer South Carolina
United States Baptist Cancer Center-Grenada Grenada Mississippi
United States Great Lakes Cancer Management Specialists-Van Elslander Cancer Center Grosse Pointe Woods Michigan
United States Ingalls Memorial Hospital Harvey Illinois
United States Geisinger Medical Center-Cancer Center Hazleton Hazleton Pennsylvania
United States OptumCare Cancer Care at Seven Hills Henderson Nevada
United States Essentia Health Hibbing Clinic Hibbing Minnesota
United States Northwest Cancer Center - Hobart Hobart Indiana
United States Saint Mary Medical Center Hobart Indiana
United States Hawaii Cancer Care Inc - Waterfront Plaza Honolulu Hawaii
United States Kapiolani Medical Center for Women and Children Honolulu Hawaii
United States Queen's Cancer Cenrer - POB I Honolulu Hawaii
United States Queen's Cancer Center - Kuakini Honolulu Hawaii
United States Queen's Medical Center Honolulu Hawaii
United States Straub Clinic and Hospital Honolulu Hawaii
United States Saint Catherine Hospital Indianapolis Indiana
United States University of Iowa/Holden Comprehensive Cancer Center Iowa City Iowa
United States Southeastern Medical Oncology Center-Jacksonville Jacksonville North Carolina
United States Queens Hospital Center Jamaica New York
United States Essentia Health - Jamestown Clinic Jamestown North Dakota
United States McFarland Clinic - Jefferson Jefferson Iowa
United States NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro Jonesboro Arkansas
United States Illinois CancerCare-Kewanee Clinic Kewanee Illinois
United States Gundersen Lutheran Medical Center La Crosse Wisconsin
United States Northwestern Medicine Lake Forest Hospital Lake Forest Illinois
United States Rocky Mountain Cancer Centers-Lakewood Lakewood Colorado
United States Memorial Medical Center - Las Cruces Las Cruces New Mexico
United States Comprehensive Cancer Centers of Nevada - Central Valley Las Vegas Nevada
United States Comprehensive Cancer Centers of Nevada - Town Center Las Vegas Nevada
United States OptumCare Cancer Care at Charleston Las Vegas Nevada
United States OptumCare Cancer Care at Fort Apache Las Vegas Nevada
United States Geisinger Medical Oncology-Lewisburg Lewisburg Pennsylvania
United States Saint Joseph Hospital East Lexington Kentucky
United States Saint Rita's Medical Center Lima Ohio
United States Trinity Health Saint Mary Mercy Livonia Hospital Livonia Michigan
United States Rocky Mountain Cancer Centers-Sky Ridge Lone Tree Colorado
United States Great Lakes Cancer Management Specialists-Macomb Medical Campus Macomb Michigan
United States Illinois CancerCare-Macomb Macomb Illinois
United States McFarland Clinic - Marshalltown Marshalltown Iowa
United States Contra Costa Regional Medical Center Martinez California
United States Carle Physician Group-Mattoon/Charleston Mattoon Illinois
United States Baptist Memorial Hospital and Cancer Center-Memphis Memphis Tennessee
United States Froedtert Menomonee Falls Hospital Menomonee Falls Wisconsin
United States Medical College of Wisconsin Milwaukee Wisconsin
United States Abbott-Northwestern Hospital Minneapolis Minnesota
United States Minneapolis VA Medical Center Minneapolis Minnesota
United States University of Minnesota/Masonic Cancer Center Minneapolis Minnesota
United States Atrium Health Union/LCI-Union Monroe North Carolina
United States The Community Hospital Munster Indiana
United States Women's Diagnostic Center - Munster Munster Indiana
United States ThedaCare Regional Medical Center - Neenah Neenah Wisconsin
United States Baptist Memorial Hospital and Cancer Center-Union County New Albany Mississippi
United States ThedaCare Cancer Care - New London New London Wisconsin
United States Cancer Center of Western Wisconsin New Richmond Wisconsin
United States New Ulm Medical Center New Ulm Minnesota
United States Delaware Clinical and Laboratory Physicians PA Newark Delaware
United States Helen F Graham Cancer Center Newark Delaware
United States Medical Oncology Hematology Consultants PA Newark Delaware
United States Piedmont Newnan Hospital Newnan Georgia
United States Cancer Care Center of O'Fallon O'Fallon Illinois
United States Drexel Town Square Health Center Oak Creek Wisconsin
United States Bay Area Tumor Institute Oakland California
United States Northwestern Medicine Orland Park Orland Park Illinois
United States ThedaCare Cancer Care - Oshkosh Oshkosh Wisconsin
United States Illinois CancerCare-Ottawa Clinic Ottawa Illinois
United States Essentia Health - Park Rapids Park Rapids Minnesota
United States Illinois CancerCare-Pekin Pekin Illinois
United States Arizona Center for Cancer Care-Peoria Peoria Arizona
United States Illinois CancerCare-Peoria Peoria Illinois
United States Illinois CancerCare-Peru Peru Illinois
United States Arizona Center for Cancer Care - Phoenix Phoenix Arizona
United States FirstHealth of the Carolinas-Moore Regional Hospital Pinehurst North Carolina
United States South Florida Baptist Hospital Plant City Florida
United States Geisinger Cancer Services-Pottsville Pottsville Pennsylvania
United States Illinois CancerCare-Princeton Princeton Illinois
United States Beebe Health Campus Rehoboth Beach Delaware
United States Valley Medical Center Renton Washington
United States UT Southwestern Clinical Center at Richardson/Plano Richardson Texas
United States West Suburban Medical Center River Forest Illinois
United States Mayo Clinic in Rochester Rochester Minnesota
United States Levine Cancer Institute-Rock Hill Rock Hill South Carolina
United States Mease Countryside Hospital Safety Harbor Florida
United States Ascension Saint Mary's Hospital Saginaw Michigan
United States Coborn Cancer Center at Saint Cloud Hospital Saint Cloud Minnesota
United States Mercy Hospital Saint Louis Saint Louis Missouri
United States Missouri Baptist Medical Center Saint Louis Missouri
United States Park Nicollet Clinic - Saint Louis Park Saint Louis Park Minnesota
United States Regions Hospital Saint Paul Minnesota
United States United Hospital Saint Paul Minnesota
United States Saint Anthony's Hospital Cancer Care Center Saint Petersburg Florida
United States Sainte Genevieve County Memorial Hospital Sainte Genevieve Missouri
United States Zuckerberg San Francisco General Hospital San Francisco California
United States Essentia Health Sandstone Sandstone Minnesota
United States Arizona Center for Cancer Care - Osborn Scottsdale Arizona
United States Arizona Center for Cancer Care - Scottsdale Scottsdale Arizona
United States Community Medical Center Scranton Pennsylvania
United States Prisma Health Cancer Institute - Seneca Seneca South Carolina
United States ThedaCare Cancer Care - Shawano Shawano Wisconsin
United States Sanford Cancer Center Oncology Clinic Sioux Falls South Dakota
United States Sanford USD Medical Center - Sioux Falls Sioux Falls South Dakota
United States Baptist Memorial Hospital and Cancer Center-Desoto Southhaven Mississippi
United States Memorial Medical Center Springfield Illinois
United States Southern Illinois University School of Medicine Springfield Illinois
United States Springfield Clinic Springfield Illinois
United States Bhadresh Nayak MD PC-Sterling Heights Sterling Heights Michigan
United States Lakeview Hospital Stillwater Minnesota
United States Piedmont Henry Hospital Stockbridge Georgia
United States Saint Vincent Hospital Cancer Center at Sturgeon Bay Sturgeon Bay Wisconsin
United States Missouri Baptist Sullivan Hospital Sullivan Missouri
United States BJC Outpatient Center at Sunset Hills Sunset Hills Missouri
United States Arizona Center for Cancer Care-Surprise Surprise Arizona
United States Sanford Thief River Falls Medical Center Thief River Falls Minnesota
United States Rocky Mountain Cancer Centers-Thornton Thornton Colorado
United States UM Saint Joseph Medical Center Towson Maryland
United States Carle Cancer Center Urbana Illinois
United States Northwest Cancer Center - Valparaiso Valparaiso Indiana
United States Essentia Health Virginia Clinic Virginia Minnesota
United States Epic Care Cyberknife Center Walnut Creek California
United States Great Lakes Cancer Management Specialists-Macomb Professional Building Warren Michigan
United States Saint John Macomb-Oakland Hospital Warren Michigan
United States Northwestern Medicine Cancer Center Warrenville Warrenville Illinois
United States Illinois CancerCare - Washington Washington Illinois
United States Marion L Shepard Cancer Center - ECU Health Beaufort Hospital Washington North Carolina
United States ThedaCare Cancer Care - Waupaca Waupaca Wisconsin
United States Froedtert West Bend Hospital/Kraemer Cancer Center West Bend Wisconsin
United States Geisinger Wyoming Valley/Henry Cancer Center Wilkes-Barre Pennsylvania
United States Rice Memorial Hospital Willmar Minnesota
United States Sanford Cancer Center Worthington Worthington Minnesota
United States Rush-Copley Healthcare Center Yorkville Illinois
United States Huron Gastroenterology PC Ypsilanti Michigan
United States Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus Ypsilanti Michigan

Sponsors (2)

Lead Sponsor Collaborator
Alliance for Clinical Trials in Oncology National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change in appetite Will be compared between the two study groups (olanzapine versus megestrol acetate) using a 0-10 numerical rating scale. Will be summarized by mean (standard deviation [SD]) and median (range) by treatment arm. The difference in appetite change from baseline to 4 weeks of treatment between arms will be estimated along with a 95% confidence interval and will be compared using a t-test or Wilcoxon rank-sum test as appropriate. Baseline up to 4 weeks
Secondary Proportion of patients who report a 5% or greater weight gain The proportion of patients with a 5% or greater weight gain from baseline will be calculated for each arm. The difference in proportion of patients with 5% or greater weight gain between the arms will be estimated along with a 95% confidence interval using a normal approximation of the binomial distribution and will be compared using a Chi-squared test. Baseline up to 4 weeks
Secondary Change in well-being status and cachexia/anorexia symptoms Responses to the Functional Assessment of Anorexia/Cachexia Treatment (FAACT)-Anorexia/Cachexia Subscale (A/CS) questionnaire will be scored according to the established algorithm. The total score of the FAACT-A/CS will be summarized weekly and the change from baseline to 4 weeks will be compared between the treatment arms using the same methods described for the primary endpoint. Baseline up to 4 weeks
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