Combination Therapy for Cancer Related Fatigue in Patients With Metastatic Cancers

Eligibility Criteria

• 1. Be advanced cancer patients (incurable metastatic), having fatigue with severity of 4/10, on a 0-10 scale (Edmonton Symptom Assessment Scale) for at least 2 weeks.
• 2. Have no clinical evidence of cognitive failure as evidenced by treating clinician assessment at screening (Memorial Delirium Assessment Scale of less than 13/30).
• 3. Be aged 18 years or older.
• 4. Be willing to engage in follow-up in person or by telephone or virtual calls with research staff.
• 5. Have a hemoglobin level of ≥10 g/dL within 2 weeks of enrollment.
• 6. Be able to understand the description of the study and sign a written informed consent.
• 7. Have a ECOG performance status score of 0 to 2; and
• 8. Be seen at an outpatient clinic at MD Anderson Cancer Center's (MDA) main campus or its Houston Area Locations (HALs)
• 1. Have a major contraindication to placebo (e.g., allergy or hypersensitivity to study medications or their constituents), or conditions making adherence difficult as determined by the attending physician.
• 2. Be unable to complete the baseline assessment forms or to understand the recommendations for participation in the study.
• 3. Be pregnant or become pregnant while on study.