Efficacy of low-dose olanzapine in preventing chemotherapy-induced nausea and vomiting in patients with steroid intolerance

Objectives: To assess the efficacy and safety of low-dose olanzapine in preventing chemotherapy-induced nausea and vomiting (CINV) in patients intolerant to corticosteroids. Material and Methods: Fifty patients receiving moderately or highly emetogenic chemotherapy were included. All patients received a standard antiemetic regimen comprising a 5-HT3 receptor antagonist, an NK1 receptor antagonist (for highly emetogenic chemotherapy), and low-dose olanzapine (2.5 mg daily for three to five days). Patients recorded episodes of nausea, vomiting, need for rescue therapy, and adverse effects. Results: CINV was observed in 6% of patients, and vomiting occurred in 2%. Sedation (12%), weight gain (4%), and increased appetite (32%) were the most commonly reported side effects. No severe toxicities were observed, and treatment adherence was high. Conclusion: Low-dose olanzapine is an effective and well-tolerated option for CINV prevention in patients unable to tolerate corticosteroids, offering a favorable safety profile.