In a progressive recent study at Tata Memorial Centre, Mumbai, a cost-effective method to control chemotherapy-induced vomiting has been discovered.
India’s largest cancer facility, TMC, has suggested that a potential low-dose Olanzapine (2.5 mg) can effectively control the vomiting induced by chemotherapy for cancer patients.
This discovery emerges as a beacon of hope for cancer patients grappling with the debilitating side effects of their treatment.
Chemotherapy, a crucial component of cancer therapy, frequently triggers nausea and vomiting. Although Olanzapine, an antipsychotic medication, has demonstrated effectiveness in mitigating these side effects, the standard dose (10 mg) brings along the troublesome side effect of excessive daytime sleepiness, hindering its widespread application.
Dr. Jyoti Bajpai, Professor of Medical Oncology at TMC and lead researcher, underscores the significance of this finding. Cancer-induced nausea often leads to extended periods of sleep, disrupting patients’ daily lives, including work and school commitments. Dr. Bajpai said in a conversation with The Sunday Express that excessive daytime sleepiness becomes a pervasive issue, impacting productivity, and attendance, and posing financial burdens as individuals struggle to maintain employment and academic responsibilities.
To address this concern, the research team embarked on innovative approaches to alleviate these adverse effects. The large-scale Phase 3 trial evaluated the efficacy of low-dose Olanzapine (2.5mg) against the standard dose (10mg) over a 4-day period, coupled with standard anti-vomiting drugs with reduced steroid content at TMC, Homi Bhabha National Institute.
The trial, conducted between February 9, 2021, and May 30, 2023, involved 267 patients aged 13–75 years undergoing chemotherapy, specifically those on regimens known for inducing nausea and vomiting in solid tumor patients.
The primary objective was to compare the two groups for “complete control,” indicating no vomiting, no need for rescue medications, and no or mild nausea throughout the 0–120 hours phase. The secondary safety objective focused on daytime sleepiness.
Results showed that 45% in the 2.5 mg Olanzapine group achieved complete control compared to 44% in the 10.0 mg group, demonstrating the non-inferiority of the 2.5 mg regimen. The small 1.0% difference indicates that the 2.5 mg treatment is just as effective as the 10.0 mg one.
Dr. Bajpai emphasizes that this 1% difference is a favorable outcome for the lower dose, showcasing its non-inferiority. Published in the Lancet Oncology, the research paper states that low-dose Olanzapine not only exhibits equal efficiency in controlling chemotherapy-induced nausea-vomiting but is also associated with fewer side effects, including reduced daytime sleepiness.
This cost-effective breakthrough holds transformative potential for global healthcare, providing relief to countless patients battling chemotherapy-induced nausea and vomiting. The reduction in daytime sleepiness is particularly significant, making low-dose Olanzapine a promising choice for improving patients’ quality of life during cancer treatment. Further detailed studies are needed to explore its utility in conditions requiring steroid restriction, such as diabetes and other immunocompromised situations.
