Effectiveness of olanzapine in patients who fail therapy with aprepitant while receiving highly emetogenic chemotherapy
- 1 January 2018
- journal article
- research article
- Published by Springer Science and Business Media LLC in Medical Oncology
- Vol. 35 (1), 12
- https://doi.org/10.1007/s12032-017-1074-3
Abstract
Chemotherapy-induced nausea-vomiting (CINV) compromises the quality of life of patients with cancer. We present data on the effectiveness of olanzapine after failure of aprepitant in patients receiving highly emetogenic chemotherapy (HEC). A single-center prospective study was conducted, where patients >= 18 years who failed aprepitant, palonosetron, dexamethasone (APD) received olanzapine, palonosetron and dexamethasone (OPD) in the subsequent cycle of HEC. Failure of APD was defined as occurrence of >= grade 2 acute and/or delayed nausea +/- vomiting. Response rates were compared with what was achieved in their previous cycle with the use of APD in the acute (0-24 h), delayed (24-120 h) and overall (0-120 h) periods after the start of HEC. Impact on life was assessed using the MD Anderson Symptom Inventory (MDASI). Fifty-five patients failed APD and received OPD in the subsequent cycle; 54 were evaluable for response. Complete response rate for OPD versus APD is 80 versus 20% (acute period), 90 versus 18% (delayed period) and 74 versus 5% (overall period), and no nausea rate for OPD versus APD is 57 versus 13% (acute), 59 versus 15% (delayed) and 48 versus 0% (overall period), p < 0.001 for all comparisons. MDASI scores showed significant improvement after switching to OPD. A mild increase in drowsiness noted in patients receiving OPD did not affect daily life in most patients. In patients receiving HEC and failing CINV prophylaxis with APD, switching to OPD regimen in the subsequent cycle greatly improves control of vomiting, increases "no nausea" rates and significantly reduces symptom severity scores.This publication has 18 references indexed in Scilit:
- Role of olanzapine in chemotherapy-induced nausea and vomiting on platinum-based chemotherapy patients: a randomized controlled studySupportive Care in Cancer, 2016
- Olanzapine for the Prevention of Chemotherapy-Induced Nausea and VomitingThe New England Journal of Medicine, 2016
- Cancer and chemotherapy-induced nausea and vomitingCurrent Opinion in Supportive & Palliative Care, 2016
- The Efficacy, Safety, and Cost Benefit of Olanzapine versus Aprepitant in Highly Emetogenic Chemotherapy: A Pilot Study from South IndiaChemotherapy Research and Practice, 2016
- Olanzapine for chemotherapy-induced nausea and vomiting: a systematic reviewSupportive Care in Cancer, 2014
- The use of olanzapine versus metoclopramide for the treatment of breakthrough chemotherapy-induced nausea and vomiting in patients receiving highly emetogenic chemotherapySupportive Care in Cancer, 2013
- A phase II trial of olanzapine, dexamethasone, and palonosetron for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier oncology group studySupportive Care in Cancer, 2007
- Delayed Nausea and Vomiting Continue to Reduce Patients' Quality of Life After Highly and Moderately Emetogenic Chemotherapy Despite Antiemetic TreatmentJournal of Clinical Oncology, 2006
- The Oral Neurokinin-1 Antagonist Aprepitant for the Prevention of Chemotherapy-Induced Nausea and Vomiting: A Multinational, Randomized, Double-Blind, Placebo-Controlled Trial in Patients Receiving High-Dose Cisplatin—The Aprepitant Protocol 052 Study GroupJournal of Clinical Oncology, 2003
- Assessing symptom distress in cancer patientsCancer, 2000