Evidence map›Paper›PMID 40324698›Full record

ArticleJournal of pain and symptom management2025

Olanzapine for Managing Side Effects From Antiangiogenic Tyrosine-Kinase Inhibitors.

Regina M Koch, Miguel Muniz, Candy S Peskey, Aminah Jatoi, Kathryn J Ruddy, Jacob J Orme, Lance C Pagliaro, Fernando Quevedo, Brian A Costello, Megan T Spychalla and 9 more

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In one paragraph

Article in Journal of pain and symptom management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Targeted therapies in pediatric oncology: A start.Molecular therapy. Oncology · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Regina M KochDepartment of Internal Medicine (R.M.K.,), Mayo Clinic, Rochester, Minnesota, USA. Electronic address: koch.regina@mayo.edu.
Miguel MunizDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Candy S PeskeyDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Aminah JatoiDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Kathryn J RuddyDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Jacob J OrmeDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Lance C PagliaroDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Fernando QuevedoDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Brian A CostelloDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Megan T SpychallaDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Elisabeth I HeathDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Yousef ZakhariaDivision of Hematology and Medical Oncology (Y.Z., P.S., I.B.R.), Mayo Clinic, Scottsdale, Arizona, USA.
Parminder SinghDivision of Hematology and Medical Oncology (Y.Z., P.S., I.B.R.), Mayo Clinic, Scottsdale, Arizona, USA.
Oliver SartorDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Irbaz B RiazDivision of Hematology and Medical Oncology (Y.Z., P.S., I.B.R.), Mayo Clinic, Scottsdale, Arizona, USA.
Elizabeth J Cathcart-RakeDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Stacy D D'AndreDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Charles L LoprinziDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.
Daniel S ChildsDepartment of Medical Oncology (M.M., C.S.P., A.J., K.J.R., J.J.O., L.C.P., F.Q., B.A.C., M.T.S., E.I.H., O.S., E.J.C.R., S.D.D.A, C.L.L., D.S.C.), Mayo Clinic, Rochester, Minnesota, USA.

Funding

Mayo Clinic Center for Clinical and Translational Science (CCaTS UL1 Supplement - Dr. Timothy Curry)UL1TR002377 · NCATS · MAYO CLINIC ROCHESTER · PI VESNA D GAROVIC · 2017 to 2026
$78.4M
NCATS NIH HHS UL1 TR002377
6 · The paper itself

Abstract

contextSide effects from tyrosine kinase inhibitors (TKIs) are common and burdensome. Olanzapine is useful for managing symptoms from conventional chemotherapy, but its role in treating TKI-related side effects is unclear.

objectivesExamine the efficacy of olanzapine for TKI-induced nausea, vomiting, anorexia, weight loss, and insomnia.

methodsAll patients prescribed olanzapine with lenvatinib, cabozantinib, axitinib, or tivozanib at Mayo Clinic between January 2018 and June 2024 were assessed for inclusion. For baseline assessment, clinical notes documenting symptoms and indication(s) for starting olanzapine were reviewed. Notes and portal messages from the first three months after starting olanzapine were then evaluated for qualitative descriptions of change in symptom burden. Data were categorized as "improved," "worsened," "stable," or "missing data," with each symptom domain analyzed independently, when olanzapine was prescribed for multiple interrelated symptoms.

resultsSixty patients received olanzapine, most commonly 5 mg (n = 37, 61.7%) or 2.5 mg (n = 16, 26.6%). Indications included nausea without vomiting (n = 35), anorexia (n = 25), nausea with vomiting (n = 16), weight loss (n = 16), and insomnia (n = 11). It was given for multiple symptoms in 32 patients. Within the first 3 months, 85% of patients had improvement in nausea without vomiting, 93% in nausea with vomiting, 74% in appetite, and 85% in sleep. Among 34 patients with weight loss prior to olanzapine, 50% gained weight (median: 6.1 kg), 26% stabilized (±1 kg), and 24% continued to lose weight. Only 4 patients discontinued olanzapine due to side effects.

conclusionOlanzapine appears effective in treating TKI-induced nausea, vomiting, anorexia, insomnia, and weight loss, warranting further investigation in prospective studies.

Indexed as

Angiogenesis InhibitorsOlanzapineProtein Kinase InhibitorsAdultAgedAnorexiaFemaleHumansMaleMiddle AgedNauseaRetrospective StudiesSleep Initiation and Maintenance DisordersTreatment OutcomeVomitingWeight LossAngiogenesis InhibitorsOlanzapineProtein Kinase InhibitorsanorexiainsomnianauseaOlanzapinetyrosine kinase inhibitorsweight loss

Identifiers

PMID40324698
PMCPMC12799100

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