@wpprescott ,

I just got into a Phase 1 trial called MOONRAY. It's a KRAS G12D inhibitor from Eli Lilly. Six pills by mouth each day. Some nausea and fatigue, but definitely tolerable after one week, with no mouth or skin issues.

I also continue to struggle with weight loss and digestion issues. My palliative ARNP has also recommended either prochlorperazine (Compazine) or olanzapine (Zyprexa), but not both together. I've avoided both because of the side effects I read about, but she said those are not common at lower doses. She also said Reglan (metaclopramide) can be take in conjunction with Olanzapine, but not with Compazine. Once I got my GI tract straightened out with Reglan last year, I stopped because of the potential side effects (and nasty taste), but the side effects are supposed to be mild with lighter dosing and limited time usage.

I've also struggled with extreme dry mouth, but only while sleeping. Everything seems to wake me up in the middle of the night. There are many causes, but anti-nausea meds are said to dry you out (reduce salivation), and that has scared me away from most of them. I've had some luck with OTC tablets called XyliMelts (from OraCoat) that you can put between gum and cheek tissue while sleeping. The same ARNP also recommended mouthwashes like Biotene (which I've already tried with little success), and an SLS-free toothpaste like Verve. (SLS is Sodium Laurel Sulfate, iirc). I haven't tried that yet. She also said you can make your own mouth rinse with about a quart of water, a tablespoon of baking soda, and a teaspoon of salt. I'll give that a shot this week.

ARPN said Olanzapine has also been shown to help with sleep as well as with appetite. Have you noticed any impact on drowsiness or sleep quality?

I can't do the medical marijuana route for various reasons, but I'm guessing you might recall the "cottonmouth" phenomenon from the 1980's. It may be more hindrance than help for you, but everyone is different. Wishing you the best, and hope you'll keep us updated.