Abstract

Nausea and vomiting the most common side effect of chemotherapy is perceived as a major adverse effect of the treatment. Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life, causing severe clinical conditions, such as electrolyte imbalances, dehydration, malnutrition and leading to treatment discontinuation. Fortunately, improvements in treatments for nausea and vomiting have been able to mitigate these adverse effects in most patients. This study aims to compare Olanzapine with Aprepitant in the prevention of CINV. Methods and Materials: The study was conducted in breast cancer patients attending the department of oncology at KR hospital. The patients who met inclusion criteria were randomized to one of these two antiemetic regimens. Group A: Aprepitant group Group B: Olanzapine group Protocol therapy was continued with each chemotherapy cycle until discontinuation of the same regimen of chemotherapy. Patients were permitted to take rescue therapy of the treating investigator’s choice for nausea and/or vomiting based on clinical circumstances. Patients were asked to record daily episodes of vomiting (number and time) and the utilization of rescue therapy. Patients were contacted telephonically to remind them to complete the forms. Results: CR for vomiting in the acute period was 91.8% and 90.4% (p=0.730); for the delayed period 67.2% and 83.3% (p=0.040); for the overall period 62.3% and 81.7% (p=0.018) for the Olanzapine and Aprepitant arm respectively. Conclusion: This study shows that Olanzapine is better than Aprepitant in terms of prevention of nausea. While Aprepitant is good in the prevention of vomiting. Hence combination of both Olanzapine and Aprepitant would mitigate both nausea and vomiting in a better way. Combination of these two agents needs to be studied in future studies.

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