Chemotherapy-induced delayed
emesis (DE) affects approximately 50-70% of patients receiving moderately and highly emetogenic
chemotherapy. DE most commonly occurs within the first 24-48 hours of
chemotherapy administration and can persist for 2-5 days.
Olanzapine, which has been used anecdotally for chronic
nausea in advanced
cancer patients, might be a useful treatment for the prevention of delayed
emesis in
chemotherapy patients. We conducted a chart review to explore this hypothesis and to plan potential studies. Using pharmacy records or an electronic medical record, we identified all patients who had received
olanzapine in the oncology clinic (n = 98). We reviewed these records and selected all patients (n = 28) who had received
olanzapine for the prevention of delayed
emesis for structured review. There were 17 women (60.7%) and 11 men (39.3%). Eleven patients (39.3%) had at least one instance of
nausea recorded while undergoing
olanzapine treatment and seven (25%) had an episode of
vomiting recorded. During 95 total cycles of
chemotherapy with
olanzapine (mean = 3.4 cycles per patient), there were 21 incidents of
nausea (22.1%) and 10 instances of
vomiting (10.5%). Side effects were rarely noted. These data suggest that
olanzapine was well tolerated and may reduce the incidence of delayed
emesis in patients receiving moderate to highly emetogenic
chemotherapy. A series of prospective trials are underway.