Abstract : To evaluate the effect of early palliative care integrated with standard oncologic care compared with standard oncologic care only on improvement of quality of life in patients with metastatic non -small cell lung cancer. 30patients diagnosed within 8 weeks as non-small cell lung cancer were included and randomized to two groups, the study group received standard oncologic care plus early palliative care in form of Oral megestrol acetate (Megace 160mg tablet, DEVA company) plus oral olanzapine (olapex 5mg tablet, Apex company) once neightly for management of anorexia and cachexia syndrome and nebulized morphine sulfate 5mg (0.5ml with 4ml normal saline) every 6 hours for management of dyspnea and management of pain according to severity of pain by using WHO ladder for cancer pain management. results revealed that the study group has high FACT-L score than the control group (95.2±13.74 versus 80±12.51) which means improve quality of life, also we found that megestrol acetate plus olanzapine improve appetite according to appetite VAS (5.73±1.03 versus 3.73±0.7) and increase body weight (60.55±8.48 versus 54.83±5.89). Early palliation of common symptoms with standard oncologic care improves quality of life in patient with metastatic non-small cell lung cancer, and the use of Megestrol acetate 160mg plus olanzapine 5mg improve appetite and increase body weight, and that Morphine sulfate nebulizer 5mg improve dyspnea but has no effect on oxygen saturation in patient with metastatic non-small cell lung cancer