ASCO: For Chemo's Nausea, Olanzapine Beats Metoclopramide

Patients with breakthrough chemo-induced nausea and vomiting benefit from olanzapine

THURSDAY, May 17 (HealthDay News) -- For patients receiving highly emetogenic chemotherapy who experience breakthrough chemotherapy-induced nausea and vomiting, treatment with olanzapine (Zyprexa) is significantly better than treatment with metoclopramide, according to a phase III study released May 16 in advance of presentation at the annual meeting of the American Society of Clinical Oncology, held from June 1 to 5 in Chicago.

Rudolph M. Navari, M.D., Ph.D., from the Indiana University School of Medicine South Bend, and colleagues conducted a randomized double-blind trial in chemotherapy-naive patients receiving highly emetogenic chemotherapy. Patients who developed breakthrough emesis or nausea, despite receiving guideline-recommended prophylactic treatment for chemotherapy-induced nausea and vomiting, were randomly allocated to receive olanzapine (42 patients) or metoclopramide (38 patients) orally for three days. Patients were monitored for 72 hours after treatment.

During the 72-hour observation period, the researchers found that 71 percent of patients receiving olanzapine and 32 percent receiving metoclopramide had no emesis (P < 0.01). During the observation period, the proportion of patients without nausea was 67 percent of those treated with olanzapine versus 24 percent of those treated with metoclopramide (P < 0.01). The investigators noted no grade 3 or 4 toxicities.

"This study suggests that olanzapine will be very useful in these patients who feel very sick and sometimes come to the clinic, hospital, or emergency room. As a result, patients will feel better," Navari said in a statement.

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