Comparative Study of Efficacy and Safety of Olanzapine as Add-on Therapy to Conventional Regimen in Preventing Chemotherapy-induced Nausea and Vomiting

Background: Chemotherapy-induced nausea and vomiting (CINV) are significant adverse effects that can severely diminish a cancer patient's quality of life and hinder their ability to adhere to and tolerate treatment.This study aims to assess the efficacy and safety of adding olanzapine, compared to placebo, to a standard antiemetic regimen of granisetron and dexamethasone for the prevention of CINV in cancer patients undergoing highly emetogenic chemotherapy.Methods: The present study is a randomized, double-blind study of 82 cancer patients receiving highly emetogenic chemotherapy (HEC) which was conducted at a tertiary care hospital in India from June 2019 to February 2020, patients were randomized (1:1) into two groups and monitored for four days post-chemotherapy. Results:The olanzapine group exhibited statistically significantly higher complete response rates than the placebo group at all measured time points.This superiority was observed during the early (0-24 hours), late (25-120 hours), and overall (0-120 hours) assessment periods.Both treatment approaches were well-tolerated, with only mild side effects reported.Conclusion: Olanzapine, as compared with placebo, significantly improved nausea prevention, as well as the complete-response rate in CINV, among previously untreated patients who were receiving highly emetogenic chemotherapy (HEC).