Olanzapine May Help to Manage Nausea, Vomiting Unrelated to Chemotherapy in Patients With Advanced Cancer

According to a recent study, olanzapine may help patients with advanced cancer manage symptoms unrelated to chemotherapy, such as nausea and vomiting. Olanzapine is a generic drug that is used to treat nervous, emotional, and mental conditions.¹

Although it’s widely understood that chemotherapy can cause adverse effects (AEs) such as nausea and vomiting, it is less widely known that patients with advanced cancer also suffer from nausea and vomiting that is not caused by chemotherapy, explained co-lead author Charles Loprinzi, MD, a Mayo Clinic medical oncologist, in a press release.²

Consequently, there is limited research available into treatments for these symptoms for patients with advanced cancer. For this reason, Loprinzi worked with co-lead author Rudolph Navari, MD, an oncologist at The University of Alabama at Birmingham, and their research team to further investigate potential treatments.¹

"Current guidelines for the management of nausea and vomiting in patients with advanced cancer have not specifically indicated that one drug looks substantially better than a variety of other drugs," Loprinzi said in the press release. "However, we believe the present results may be viewed as a best practice for treating nausea and vomiting in patients with advanced cancer-associated nausea and vomiting."²

The researchers conducted a randomized, placebo-controlled, double-blind trial in 30 patients with advanced cancer who had not recently received chemotherapy or radiation therapy but did have nausea and vomiting symptoms. Patients were then randomly assigned a low-dose of olanzapine or a placebo daily.¹

Before beginning treatment, patients rated their nausea over the past 24-hour period on a scale of 0 to 10, with 0 being none and 10 being as bad as is conceivable. Participants would then rate their nausea every day of the trial at about the same time of day for the rest of the study period.¹

When assessing the results, the researchers found that all 30 participants recorded nausea scores of 8 to 10 on the first day of the trial. After 8 days, nausea scores in the 15 patients who received a placebo remained at 8 to 10 out of 10.¹

However, the 15 patients who received olanzapine had scores of 2 to 3 out of 10 after 1 day and 0 to 3 out of 10 after 7 days. Correspondingly, these patients also noted that they experienced less vomiting, better appetite, and improved well-being while on the treatment. No patient-reported AEs were observed among the participants receiving olanzapine.¹

"Olanzapine given at 5 milligrams per day for 7 days markedly improved patient quality of life with no side effects," Navari said in the press release. "And as a generic drug, it's also relatively affordable, with a one-month supply often costing anywhere from $10 to $15."²

REFERENCES

• Navari RM, Pywell CM, Le-Rademacher JG, et al. Olanzapine for the Treatment of Advanced Cancer-Related Chronic Nausea and/or Vomiting. JAMA Oncology. 2020. doi: 10.1001/jamaoncol.2020.1052.
• Olanzapine may help control nausea, vomiting in patients with advanced cancer [news release]. MayoClinic; May 7, 2020. sciencedaily.com/releases/2020/05/200507164005.htm. Accessed June 4, 2020.