If it does not improve, your provider can evaluate a slight dose reduction, advise reducing caffeine and other stimulants, or discuss alternative appetite suppressants such as Tenuate or Phendimetrazine, which work through different mechanisms and tend to cause less sleep disruption

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Patient-derived glioblastoma organoids reflect tumor heterogeneity and treatment sensitivity
[DOI] [PubMed] [Google Scholar] 249.Malech HL, Gallin JI
At the protocol specified final OS analysis, the median in the pemetrexed in combination with pembrolizumab and platinum chemotherapy arm was 22.0 months (95% CI: 19.5, 24.5) compared to 10.6 months (95% CI: 8.7, 13.6) in the placebo with pemetrexed and platinum chemotherapy arm, with an HR of 0.56 (95% CI: 0.46, 0.69)