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Olanzapine Eases Chemo-Induced Nausea and Vomiting
TOPLINE:
, reduced need for rescue medications, and improved quality of life in patients with solid malignant tumors at moderate risk for chemotherapy-induced nausea and vomiting, a new analysis finds.
METHODOLOGY:
- Chemotherapy-induced nausea and vomiting can impact quality of life in patients with cancer. Olanzapine — an atypical antipsychotic agent — has been approved as part of antiemetic prophylaxis in patients receiving chemotherapy regimens that come with a high risk for nausea and vomiting; the agent may also help those at more moderate risk for chemotherapy-induced nausea and vomiting.
- Researchers evaluated whether receiving antiemetic prophylaxis with olanzapine reduced nausea and vomiting and improved complete response rates in patients at more moderate risk for chemotherapy-induced nausea and vomiting.
- In the phase 3 randomized study, 544 patients (median age, 51 years) with solid malignant tumors received either oxaliplatin-, irinotecan-, or carboplatin-based chemotherapy regimens at three institutes in India and were randomly assigned to antiemetic prophylaxis that included dexamethasone, aprepitant, and palonosetron with or without 10 mg olanzapine.
- The primary endpoint was the rate of complete response — defined as no vomiting, a nausea score < 5 on the visual analog scale, and no use of rescue medications during the first 120 hours of chemotherapy. Secondary endpoints included the proportion of patients who experienced nausea or chemotherapy-induced nausea and vomiting and who received rescue medications.
TAKEAWAY:
- Overall, patients who received olanzapine had a significantly higher complete response rate (91%) than those not receiving olanzapine (82%). This effect was significant after 25 hours (92% vs 83%; P = .001) but not within the first 24 hours of the chemotherapy cycle (96% vs 94%; P = .53).
- The addition of olanzapine improved complete response rates in patients who received oxaliplatin-based chemotherapy (odds ratio [OR], 0.36) and carboplatin-based chemotherapy (OR, 0.23) but not irinotecan-based chemotherapy (OR, 2.36; 95% CI, 0.23-24.25).
- Olanzapine led to better nausea control, with 96% of patients achieving a nausea score < 5 on the visual analog scale compared with 87% in the observation group (P < .001) as well as eased chemotherapy-induced nausea and vomiting (96% vs 91%; P = .02). Olanzapine also reduced the need for rescue medications — only 4% of patients in the olanzapine group received rescue medications vs 11% of patients not receiving olanzapine — and improved patients’ quality of life.
- However, 10% of the patients in the olanzapine group experienced grade 1 somnolence, whereas none in the observation group reported this side effect.
IN PRACTICE:
“Olanzapine 10 mg, combined with aprepitant, palonosetron, and dexamethasone, improved complete response rates compared with no olanzapine,” the authors concluded. “These findings suggest that this regimen could be considered as one of the standards of antiemetic therapy” in patients receiving chemotherapy regimens associated with a moderate risk for chemotherapy-induced nausea and vomiting.
SOURCE:
The study, led by Vikas Ostwal, DM, Tata Memorial Centre, Mumbai, India, was published online in JAMA Network Open.
LIMITATIONS:
The lack of a placebo group could affect the interpretation of the results. The study evaluated only a 10-mg dose of olanzapine but did not consider a lower (5-mg) dose. Other potential side effects of olanzapine, such as increased appetite or constipation, were not reported. The study predominantly involved patients with gastrointestinal cancers receiving oxaliplatin-containing regimens, which may limit the generalizability of the findings.
DISCLOSURES:
The study was supported by grants from Intas Pharmaceuticals, Zydus Lifesciences, and Dr. Reddy’s Laboratories to Tata Memorial Centre. Several authors reported receiving grants and having other ties with various sources.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
TOPLINE:
, reduced need for rescue medications, and improved quality of life in patients with solid malignant tumors at moderate risk for chemotherapy-induced nausea and vomiting, a new analysis finds.
METHODOLOGY:
- Chemotherapy-induced nausea and vomiting can impact quality of life in patients with cancer. Olanzapine — an atypical antipsychotic agent — has been approved as part of antiemetic prophylaxis in patients receiving chemotherapy regimens that come with a high risk for nausea and vomiting; the agent may also help those at more moderate risk for chemotherapy-induced nausea and vomiting.
- Researchers evaluated whether receiving antiemetic prophylaxis with olanzapine reduced nausea and vomiting and improved complete response rates in patients at more moderate risk for chemotherapy-induced nausea and vomiting.
- In the phase 3 randomized study, 544 patients (median age, 51 years) with solid malignant tumors received either oxaliplatin-, irinotecan-, or carboplatin-based chemotherapy regimens at three institutes in India and were randomly assigned to antiemetic prophylaxis that included dexamethasone, aprepitant, and palonosetron with or without 10 mg olanzapine.
- The primary endpoint was the rate of complete response — defined as no vomiting, a nausea score < 5 on the visual analog scale, and no use of rescue medications during the first 120 hours of chemotherapy. Secondary endpoints included the proportion of patients who experienced nausea or chemotherapy-induced nausea and vomiting and who received rescue medications.
TAKEAWAY:
- Overall, patients who received olanzapine had a significantly higher complete response rate (91%) than those not receiving olanzapine (82%). This effect was significant after 25 hours (92% vs 83%; P = .001) but not within the first 24 hours of the chemotherapy cycle (96% vs 94%; P = .53).
- The addition of olanzapine improved complete response rates in patients who received oxaliplatin-based chemotherapy (odds ratio [OR], 0.36) and carboplatin-based chemotherapy (OR, 0.23) but not irinotecan-based chemotherapy (OR, 2.36; 95% CI, 0.23-24.25).
- Olanzapine led to better nausea control, with 96% of patients achieving a nausea score < 5 on the visual analog scale compared with 87% in the observation group (P < .001) as well as eased chemotherapy-induced nausea and vomiting (96% vs 91%; P = .02). Olanzapine also reduced the need for rescue medications — only 4% of patients in the olanzapine group received rescue medications vs 11% of patients not receiving olanzapine — and improved patients’ quality of life.
- However, 10% of the patients in the olanzapine group experienced grade 1 somnolence, whereas none in the observation group reported this side effect.
IN PRACTICE:
“Olanzapine 10 mg, combined with aprepitant, palonosetron, and dexamethasone, improved complete response rates compared with no olanzapine,” the authors concluded. “These findings suggest that this regimen could be considered as one of the standards of antiemetic therapy” in patients receiving chemotherapy regimens associated with a moderate risk for chemotherapy-induced nausea and vomiting.
SOURCE:
The study, led by Vikas Ostwal, DM, Tata Memorial Centre, Mumbai, India, was published online in JAMA Network Open.
LIMITATIONS:
The lack of a placebo group could affect the interpretation of the results. The study evaluated only a 10-mg dose of olanzapine but did not consider a lower (5-mg) dose. Other potential side effects of olanzapine, such as increased appetite or constipation, were not reported. The study predominantly involved patients with gastrointestinal cancers receiving oxaliplatin-containing regimens, which may limit the generalizability of the findings.
DISCLOSURES:
The study was supported by grants from Intas Pharmaceuticals, Zydus Lifesciences, and Dr. Reddy’s Laboratories to Tata Memorial Centre. Several authors reported receiving grants and having other ties with various sources.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
TOPLINE:
, reduced need for rescue medications, and improved quality of life in patients with solid malignant tumors at moderate risk for chemotherapy-induced nausea and vomiting, a new analysis finds.
METHODOLOGY:
- Chemotherapy-induced nausea and vomiting can impact quality of life in patients with cancer. Olanzapine — an atypical antipsychotic agent — has been approved as part of antiemetic prophylaxis in patients receiving chemotherapy regimens that come with a high risk for nausea and vomiting; the agent may also help those at more moderate risk for chemotherapy-induced nausea and vomiting.
- Researchers evaluated whether receiving antiemetic prophylaxis with olanzapine reduced nausea and vomiting and improved complete response rates in patients at more moderate risk for chemotherapy-induced nausea and vomiting.
- In the phase 3 randomized study, 544 patients (median age, 51 years) with solid malignant tumors received either oxaliplatin-, irinotecan-, or carboplatin-based chemotherapy regimens at three institutes in India and were randomly assigned to antiemetic prophylaxis that included dexamethasone, aprepitant, and palonosetron with or without 10 mg olanzapine.
- The primary endpoint was the rate of complete response — defined as no vomiting, a nausea score < 5 on the visual analog scale, and no use of rescue medications during the first 120 hours of chemotherapy. Secondary endpoints included the proportion of patients who experienced nausea or chemotherapy-induced nausea and vomiting and who received rescue medications.
TAKEAWAY:
- Overall, patients who received olanzapine had a significantly higher complete response rate (91%) than those not receiving olanzapine (82%). This effect was significant after 25 hours (92% vs 83%; P = .001) but not within the first 24 hours of the chemotherapy cycle (96% vs 94%; P = .53).
- The addition of olanzapine improved complete response rates in patients who received oxaliplatin-based chemotherapy (odds ratio [OR], 0.36) and carboplatin-based chemotherapy (OR, 0.23) but not irinotecan-based chemotherapy (OR, 2.36; 95% CI, 0.23-24.25).
- Olanzapine led to better nausea control, with 96% of patients achieving a nausea score < 5 on the visual analog scale compared with 87% in the observation group (P < .001) as well as eased chemotherapy-induced nausea and vomiting (96% vs 91%; P = .02). Olanzapine also reduced the need for rescue medications — only 4% of patients in the olanzapine group received rescue medications vs 11% of patients not receiving olanzapine — and improved patients’ quality of life.
- However, 10% of the patients in the olanzapine group experienced grade 1 somnolence, whereas none in the observation group reported this side effect.
IN PRACTICE:
“Olanzapine 10 mg, combined with aprepitant, palonosetron, and dexamethasone, improved complete response rates compared with no olanzapine,” the authors concluded. “These findings suggest that this regimen could be considered as one of the standards of antiemetic therapy” in patients receiving chemotherapy regimens associated with a moderate risk for chemotherapy-induced nausea and vomiting.
SOURCE:
The study, led by Vikas Ostwal, DM, Tata Memorial Centre, Mumbai, India, was published online in JAMA Network Open.
LIMITATIONS:
The lack of a placebo group could affect the interpretation of the results. The study evaluated only a 10-mg dose of olanzapine but did not consider a lower (5-mg) dose. Other potential side effects of olanzapine, such as increased appetite or constipation, were not reported. The study predominantly involved patients with gastrointestinal cancers receiving oxaliplatin-containing regimens, which may limit the generalizability of the findings.
DISCLOSURES:
The study was supported by grants from Intas Pharmaceuticals, Zydus Lifesciences, and Dr. Reddy’s Laboratories to Tata Memorial Centre. Several authors reported receiving grants and having other ties with various sources.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
Dermatofibrosarcoma Protuberans More Common In Black Patients, Analysis Finds
TOPLINE:
that also found that larger tumor size and older age were associated with survival outcomes.
METHODOLOGY:
- Researchers used the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registry from 2000 through 2018 to provide a comprehensive report on the incidence of DFSP, a rare, low-grade cutaneous soft tissue sarcoma, and factors associated with metastatic progression, overall survival (OS), and cancer-specific survival.
- A total of 7748 patients (mean age, 43.5 years; 53.3% women; 52% non-Hispanic White) were diagnosed with histologically confirmed DFSP of the skin and connective tissue and were included in the study.
- DFSP incidence was reported as cases per million person-years and age-adjusted to the 2000 US Standard Population, and factors influencing metastasis were assessed.
TAKEAWAY:
- The overall DFSP incidence rate was 6.25 cases per million person-years, with a higher incidence in Black individuals than in White individuals (8.74 vs 4.53).
- The 5-year OS rate was 95.8%. Older age (≥ 60 years; hazard ratio [HR], 6.66), male gender assigned at birth (HR, 1.79), and larger tumor size (≥ 3 cm; HR, 2.02) were associated with poorer OS (P < .001 for all).
- The 1-year and 5-year DFSP-specific survival rates were 99.9% and 99.2%, respectively. Older age (HR, 3.47; P < .001) and larger tumor size (≥ 3 cm; HR, 5.34; P = .002) were associated with significantly worse cancer-specific survival.
- Large tumor size (odds ratio [OR], 2.24) and DFSP located on the head and neck (OR, 4.88), or genitalia (OR, 3.16) were significantly associated with increased metastasis risk. Higher socioeconomic status was linked to a lower risk for metastasis.
IN PRACTICE:
“Our findings highlight the increased incidence rates of DFSP among Black patients. We demonstrate the interplay between patient demographics and clinical factors in influencing DFSP metastasis, OS, and cancer-specific survival,” the authors wrote. The results, they added, “may be useful for further evaluation of proposed causes, which will ultimately lead to further understanding and prevention of this disease.”
SOURCE:
The study was led by Jalal Maghfour, MD, Department of Dermatology, Henry Ford Health, Detroit, and was published online on June 20 in the Journal of the American Academy of Dermatology.
LIMITATIONS:
Details on specific cases in the SEER registry are limited. For 1752 patients, tumor size was not included, increasing the risk for misclassification bias. Because specific pathology reports were not available, the analysis did not address histologic grade.
DISCLOSURES:
The study did not receive any funding support. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
TOPLINE:
that also found that larger tumor size and older age were associated with survival outcomes.
METHODOLOGY:
- Researchers used the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registry from 2000 through 2018 to provide a comprehensive report on the incidence of DFSP, a rare, low-grade cutaneous soft tissue sarcoma, and factors associated with metastatic progression, overall survival (OS), and cancer-specific survival.
- A total of 7748 patients (mean age, 43.5 years; 53.3% women; 52% non-Hispanic White) were diagnosed with histologically confirmed DFSP of the skin and connective tissue and were included in the study.
- DFSP incidence was reported as cases per million person-years and age-adjusted to the 2000 US Standard Population, and factors influencing metastasis were assessed.
TAKEAWAY:
- The overall DFSP incidence rate was 6.25 cases per million person-years, with a higher incidence in Black individuals than in White individuals (8.74 vs 4.53).
- The 5-year OS rate was 95.8%. Older age (≥ 60 years; hazard ratio [HR], 6.66), male gender assigned at birth (HR, 1.79), and larger tumor size (≥ 3 cm; HR, 2.02) were associated with poorer OS (P < .001 for all).
- The 1-year and 5-year DFSP-specific survival rates were 99.9% and 99.2%, respectively. Older age (HR, 3.47; P < .001) and larger tumor size (≥ 3 cm; HR, 5.34; P = .002) were associated with significantly worse cancer-specific survival.
- Large tumor size (odds ratio [OR], 2.24) and DFSP located on the head and neck (OR, 4.88), or genitalia (OR, 3.16) were significantly associated with increased metastasis risk. Higher socioeconomic status was linked to a lower risk for metastasis.
IN PRACTICE:
“Our findings highlight the increased incidence rates of DFSP among Black patients. We demonstrate the interplay between patient demographics and clinical factors in influencing DFSP metastasis, OS, and cancer-specific survival,” the authors wrote. The results, they added, “may be useful for further evaluation of proposed causes, which will ultimately lead to further understanding and prevention of this disease.”
SOURCE:
The study was led by Jalal Maghfour, MD, Department of Dermatology, Henry Ford Health, Detroit, and was published online on June 20 in the Journal of the American Academy of Dermatology.
LIMITATIONS:
Details on specific cases in the SEER registry are limited. For 1752 patients, tumor size was not included, increasing the risk for misclassification bias. Because specific pathology reports were not available, the analysis did not address histologic grade.
DISCLOSURES:
The study did not receive any funding support. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
TOPLINE:
that also found that larger tumor size and older age were associated with survival outcomes.
METHODOLOGY:
- Researchers used the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registry from 2000 through 2018 to provide a comprehensive report on the incidence of DFSP, a rare, low-grade cutaneous soft tissue sarcoma, and factors associated with metastatic progression, overall survival (OS), and cancer-specific survival.
- A total of 7748 patients (mean age, 43.5 years; 53.3% women; 52% non-Hispanic White) were diagnosed with histologically confirmed DFSP of the skin and connective tissue and were included in the study.
- DFSP incidence was reported as cases per million person-years and age-adjusted to the 2000 US Standard Population, and factors influencing metastasis were assessed.
TAKEAWAY:
- The overall DFSP incidence rate was 6.25 cases per million person-years, with a higher incidence in Black individuals than in White individuals (8.74 vs 4.53).
- The 5-year OS rate was 95.8%. Older age (≥ 60 years; hazard ratio [HR], 6.66), male gender assigned at birth (HR, 1.79), and larger tumor size (≥ 3 cm; HR, 2.02) were associated with poorer OS (P < .001 for all).
- The 1-year and 5-year DFSP-specific survival rates were 99.9% and 99.2%, respectively. Older age (HR, 3.47; P < .001) and larger tumor size (≥ 3 cm; HR, 5.34; P = .002) were associated with significantly worse cancer-specific survival.
- Large tumor size (odds ratio [OR], 2.24) and DFSP located on the head and neck (OR, 4.88), or genitalia (OR, 3.16) were significantly associated with increased metastasis risk. Higher socioeconomic status was linked to a lower risk for metastasis.
IN PRACTICE:
“Our findings highlight the increased incidence rates of DFSP among Black patients. We demonstrate the interplay between patient demographics and clinical factors in influencing DFSP metastasis, OS, and cancer-specific survival,” the authors wrote. The results, they added, “may be useful for further evaluation of proposed causes, which will ultimately lead to further understanding and prevention of this disease.”
SOURCE:
The study was led by Jalal Maghfour, MD, Department of Dermatology, Henry Ford Health, Detroit, and was published online on June 20 in the Journal of the American Academy of Dermatology.
LIMITATIONS:
Details on specific cases in the SEER registry are limited. For 1752 patients, tumor size was not included, increasing the risk for misclassification bias. Because specific pathology reports were not available, the analysis did not address histologic grade.
DISCLOSURES:
The study did not receive any funding support. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.