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Role of olanzapine in chemotherapy-induced nausea and vomiting on platinum-based chemotherapy patients: a randomized controlled study

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Abstract

Purpose

Even with the use of modern antiemetic drugs, chemotherapy-induced nausea and vomiting (CINV) is still a cause of great distress to the patients. Olanzapine, primarily marketed as an antipsychotic, was found to reduce nausea and vomiting in some chemotherapy patients. But it was never tested in Indian population with a diverse genetic background. The present study aims to evaluate the role of olanzapine in CINV in patients receiving platinum-based chemotherapy.

Methods

The study was a randomized, controlled, assessor-blinded study on 100 chemotherapy-naïve consenting patients receiving any one from cisplatin, carboplatin or oxaliplatin. The control group (n = 50) received palonosetron and dexamethasone in the approved therapeutic dose from the day 1 of chemotherapy. The test group (n = 50) received additional olanzapine 10 mg/day from day 1 for five consecutive days. CINV and quality of life (QoL) were assessed.

Results

Vomiting was significantly less among the olanzapine-treated patients. Control of delayed emesis was significantly better in this group (complete response among 96 vs. 42 % in the control group, p value <0.0001). Incidence and severity of nausea was significantly less in this group. Failure of anti-CINV measure was 4 % in this group compared to 26 % of the patients of the control group during overall days 1–5. Though sedation was more in these olanzapine-treated patients, there was no dose-limiting adverse event. Quality of life was also better among the olanzapine-treated patients.

Conclusion

Olanzapine was found to be effective as add-on in the control of CINV.

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Acknowledgments

The authors would like to thank Dr. Basabdatta Samanta, Department of Biochemistry; Dr. Rajesh Issac and Ms. Paramdeep Kaur of the Department of Community Medicine; Dr. Jaineet Sachdeva, Dr. Preeti Negi, Dr. Sapna Marcus, Dr. Abdidha Malik, Dr. Deepti AP, Dr. Parneet Singh, Dr. Jaspinder Kaur, Dr. Babusa Kalra, Dr. Romi Grover, Ms. Rashmeet Sond, Ms. Geetanjali Dutta, Ms. Nirmal, Mr. Johny and Mr. Rajesh of the Department of Radiotherapy and Day Care Center; Dr. Kunal Jain of the Department of Medical Oncology; Ms. Pritty Titus, statistician, of the Department of Neurology, Christian Medical College & Hospital, Ludhiana.

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Authors and Affiliations

  1. Faculty of Pharmacology & Assistant Coordinator of Pharmacovigilance, Department of Pharmacology, Burdwan Medical College, Burdwan, West Bengal, PIN-713102, India

    Sandip Mukhopadhyay

  2. Department of Pharmacology, Christian Medical College, Ludhiana, Punjab, PIN-141008, India

    Gagandeep Kwatra & Dinesh Badyal

  3. Department of Radiation Oncology, Christian Medical College, Ludhiana, Punjab, PIN-141008, India

    Pamela Alice K

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  1. Sandip Mukhopadhyay
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Correspondence to Sandip Mukhopadhyay.

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The authors have no financial disclosure, and the study was not a sponsored study.

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Mukhopadhyay, S., Kwatra, G., Alice K, P. et al. Role of olanzapine in chemotherapy-induced nausea and vomiting on platinum-based chemotherapy patients: a randomized controlled study. Support Care Cancer 25, 145–154 (2017). https://doi.org/10.1007/s00520-016-3386-9

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  • DOI: https://doi.org/10.1007/s00520-016-3386-9

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