A study published last week in JAMA Oncology reports that a generic drug called Olanzapine could be useful for cancer patients managing nausea and vomiting unrelated to chemotherapy. Olanzapine typically treats nervous, emotional and mental conditions, but new research suggests it could also help patients with advanced cancer.
"It's well-appreciated by most people that patients receiving cancer chemotherapy suffer from nausea and vomiting," explains Dr. Charles Loprinzi, M.D., a Mayo Clinic medical oncologist, who collaborated with Rudolph Navari, M.D., on this study. "However, it's less well-appreciated that patients with advanced cancer also have significant problems with nausea and vomiting that are unrelated to chemotherapy."
In order to address this concern, Dr. Loprinzi and Dr. Navari conducted a randomized, placebo-controlled clinical trial in 30 patients with advanced cancer experiencing nausea and vomiting who had not recently received chemotherapy or radiation therapy. Randomly assigned patients were administered a low-dose of olanzapine or a placebo daily and participants rated their nausea on a scale of 0-10 (with 0 being none and 10 being the worst) every day at about the same time of day for the duration of the study.
"Olanzapine given at 5 milligrams per day for seven days markedly improved patient quality of life with no side effects," says Dr. Navari. "And as a generic drug, it's also relatively affordable, with a one-month supply often costing anywhere from $10 to $15."
Indeed, the changes were quite convincing. Of the patients receiving olanzapine, their nausea ratings fell from 8-10 on the first day of the study to 2-3 out of 10 after one day and 0-3 out of 10 after one week. That’s compared to the 15 patients who received a placebo who all still reported a 8-10 out of 10 after one day and one week.
As Eureka Alert reports, “Correspondingly, these patients reported less vomiting, better appetite and better well-being. No patient-reported adverse events were observed among trial participants receiving olanzapine.”
The doctors think that their findings are arriving just in time. "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," says Dr. Loprinzi. "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."