Olanzapine Reduces Nausea and Improves Quality of Life for Patients with Cancer During Chemotherapy

New Research Will Be Presented at 2024 ASCO Quality Care Symposium

ASCO Perspective Quote

"Chemotherapy-induced nausea is a highly prevalent and distressing side effect of chemotherapy, which significantly impairs patients' quality of life. The findings of this study positions olanzapine as a promising intervention for patients with refractory chemotherapy-induced nausea." - Oreofe O. Odejide, MD, MPH, Medical Oncologist, Dana-Farber Cancer Institute

Study at-a-Glance

Focus	Management of chemotherapy-induced nausea
Population	1,363 people with breast cancer who were about to begin chemotherapy
Main Takeaway	Olanzapine helps reduce nausea and improve overall quality of life for patients during chemotherapy.
Significance	Nausea and vomiting are common side effects of chemotherapy for people with cancer and vomiting can interfere with a person's quality of life, making daily tasks more challenging to complete. They can also make cancer treatment more difficult to tolerate. During chemotherapy, nausea and vomiting are often treated using medications called antiemetics. However, while antiemetics are very effective at controlling vomiting during chemotherapy, nausea is still a common issue for patients. Olanzapine and prochlorperazine are two types of antiemetics. Olanzapine works by targeting receptors in the brain that cause nausea, while prochlorperazine works by blocking substances in the body that lead to nausea. Both drugs are included in ASCO guideline recommendations for treating nausea and are usually given in combination with other antiemetics to increase their effectiveness. It was unknown which drug ultimately works better for treating nausea during chemotherapy.

ALEXANDRIA, Va. - A new study found that olanzapine may be more effective at controlling severe nausea and improving the quality of life for people with cancer being treated with chemotherapy. These findings will be presented at the 2024 American Society of Clinical Oncology (ASCO) Quality Care Symposium, taking place September 27-28, 2024, in San Francisco, California.

About the Study

In this study, patients received the standard ASCO-recommended anti-nausea treatment during their first cycle of chemotherapy. The researchers then counted how many patients experienced at least moderate nausea. This meant the patients scored their nausea a 3 or higher on a scale of 1 to 7, with 7 being extreme nausea.

Of the initial 1,363 participants, 310 experienced at least moderate nausea during their first cycle of chemotherapy and agreed to continue with the study. These patients were then randomly assigned to receive either olanzapine, prochlorperazine, or a placebo in combination with the standard anti-nausea treatment during their next cycle of chemotherapy. After receiving the treatment, the patients used a diary at home for 4 days to record their level of nausea 4 times a day, as well as the number of vomiting episodes, nausea medications taken, and whether they visited the emergency department.

Key Findings

• Both olanzapine and prochlorperazine significantly reduced nausea during chemotherapy compared to the placebo.
  • In both the olanzapine and prochlorperazine groups, the average nausea score decreased by about 1 point on the nausea scale after patients received the treatment.
  • For severe nausea, olanzapine was more effective than prochlorperazine.
  • The patients who received olanzapine saw a 2.5-point decrease in their maximum nausea score compared to a 2-point decrease for those receiving prochlorperazine.
• Additionally, the patients who received olanzapine saw a significant improvement in their overall quality of life compared to the placebo group, while those who received prochlorperazine did not.

"These important findings highlight the potential for olanzapine to provide more effective relief for patients who suffer from severe nausea despite standard antiemetic treatments. This is valuable evidence for health care providers to help guide treatment strategies. For patients, this means there may be a more effective option available to improve their symptoms and overall well-being during chemotherapy. This could ultimately make the chemotherapy experience more tolerable and manageable, contributing to better overall outcomes and patient satisfaction," said lead study author Luke Peppone, PhD, University of Rochester Medical Center, Rochester, New York.

Next Steps

The researchers plan to look at how olanzapine and prochlorperazine affect nausea based on the type of chemotherapy and by the known potential of the chemotherapy to cause nausea. They are also looking at biological samples from patients to identify biomarkers that could predict nausea levels and identify which patients may be most likely to develop significant nausea.

This study was funded by the National Cancer Institute.

View the full abstract

View author disclosures

View the News Planning Team disclosures: https://society.asco.org/sites/new-www.asco.org/files/content-files/about-asco/pdf/2024-QCS-NPT-Disclosures.pdf

ATTRIBUTION TO THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY QUALITY CARE SYMPOSIUM IS REQUESTED IN ALL COVERAGE.

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