Abstract
This study was conducted to investigate the safety and efficacy of olanzapine for high and moderate emetogenic chemotherapy in children and young adults. We retrospectively reviewed the records of pediatric patients (n = 13) with cancer who had been administered olanzapine as an anti-emetic drug (AED) during a high and moderate emetogenic chemotherapy block from January 2018 to March 2020. Patients were administered other prophylactic AEDs according to practice guidelines. The mean age of the patients was 14.1 ± 5.5 years. The total number of chemotherapy cycles was 41. Twenty-one (51.2%) chemotherapy blocks were high emetogenic chemotherapy and 20 (48.8%) blocks were moderate emetogenic chemotherapy. Olanzapine was used for prophylaxis in 20 (48.8%) blocks of chemotherapy and rescue in 21 (51.2%). Of the 41 cycles, a complete response to olanzapine was achieved in 31 (75.6%), partial response in 6 (14.6%), and no response in 4 (9.8%). The mean dose was 0.07 ± 0.04 mg/kg/dose and 2.50 ± 1.37 mg/m2/dose. Adverse effects included somnolence, hyperglycemia, fatigue, and disturbed sleep. Our findings indicate that olanzapine was effective and safe for treating chemotherapy-induced nausea and vomiting in children. A prospective controlled study is needed to confirm these findings.
Highlights
Chemotherapy-induced nausea and vomiting (CINV) is a frequent and potentially treatmentlimiting complication of cancer therapy in both adults and children [1]
Despite the appropriate use of prophylactic antiemetics, breakthrough and refractory CINV often occurs, for which there is no effective treatment in children [2,3]
The findings revealed an effective antiemetic effect compared with aprepitant or metoclopramide and other combinations of antiemetic drug (AED) [9,10,11,12,13,14,15]
Summary
Chemotherapy-induced nausea and vomiting (CINV) is a frequent and potentially treatmentlimiting complication of cancer therapy in both adults and children [1]. Olanzapine is well-known as an antipsychotic drug used to treat schizophrenia and depression in children and adolescents [4,5,6,7]. It has long been used in children because of its safety [8]. Olanzapine exerts antiemetic effects by acting on various neurotransmitters that cause vomiting and nausea [4]. Recent studies have investigated the use of olanzapine as an antiemetic drug (AED) in adult patients undergoing chemotherapy. The findings revealed an effective antiemetic effect compared with aprepitant or metoclopramide and other combinations of AEDs [9,10,11,12,13,14,15]
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