title: Olanzapine for the prophylaxis and rescue of chemotherapy-induced nausea and vomiting (CINV): a retrospective study.
abstract: While the efficacy of olanzapine in the prophylaxis of chemotherapy-induced nausea and vomiting (CINV) has been documented, the literature on the use of olanzapine as a rescue medication for breakthrough CINV has been scarce. The following study retrospectively evaluated the safety and efficacy of olanzapine for the treatment of breakthrough CINV. The efficacy and safety of olanzapine in the prophylactic setting was also examined in a smaller cohort.
  
  
  
  Electronic medical records of adult patients aged >17 years receiving a prescription for olanzapine from the Odette Cancer Centre Pharmacy at Sunnybrook Hospital between January 2013 and June 2015 were reviewed retrospectively. Inclusion criteria required receiving one or more doses of olanzapine for the rescue or prophylaxis of CINV and documentation of the outcome.
  
  
  
  A total of 154 patients and 193 treatment cycles were included in the breakthrough setting, while a total of 16 patients and 20 treatment cycles were included in the prophylaxis setting. In the breakthrough setting, 88% of cases experienced improved nausea, while 21% of cases reported improved vomiting. In the prophylactic setting, 100% of cases experienced improved nausea, while 65% achieved improved vomiting. A total of 43% of cases in the breakthrough setting and 65% of cases in the prophylactic setting experienced sedation.
  
  
  
  Olanzapine is effective in improving CINV in both the prophylactic and breakthrough settings. The safety, efficacy, and appropriate dosage of olanzapine for the rescue of breakthrough CINV should be prospectively evaluated in a randomized controlled trial (RCT).
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Leonard
authors.initials: L
authors.lastname: Chiu
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Chiu
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Ronald
authors.initials: R
authors.lastname: Chow
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Liying
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Pasetka
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Jordan
authors.initials: J
authors.lastname: Stinson
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Breanne
authors.initials: B
authors.lastname: Lechner
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Natalie
authors.initials: N
authors.lastname: Pulenzas
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Sunil
authors.initials: S
authors.lastname: Verma
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada. edward.chow@sunnybrook.ca.
authors.forename: Edward
authors.initials: E
authors.lastname: Chow
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Carlo
authors.initials: C
authors.lastname: DeAngelis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage* / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D009369:Neoplasms / Q000188:drug therapy; D000077152:Olanzapine; D012189:Retrospective Studies; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D001569:Benzodiazepines; D000077152:Olanzapine
keywords: Olanzapine; breakthrough emesis; chemotherapy-induced nausea and vomiting (CINV); efficacy; prophylaxis