Doctors from the renowned cancer care center, Tata Memorial Centre in Parel, Mumbai, have once again demonstrated innovation by devising a smaller and lower-cost dosage of a well-known drug used to control chemotherapy-related vomiting and nausea. Their research, which involves reducing the globally prescribed standard dosage to a quarter, has been published in the peer-reviewed medical journal, The Lancet Oncology, reported in Times of India. The focus of their study was on the drug olanzapine, widely used as an antipsychotic medication for patients with schizophrenia and bipolar disorder. Olanzapine is also prescribed to cancer patients undergoing chemotherapy to mitigate side effects such as vomiting and nausea.
"While the standard prescription globally was 10mg of olanzapine for patients undergoing chemotherapy to reduce vomiting and nausea, our research demonstrated that a lower dose of olanzapine (2.5mg) is equally efficient in controlling chemotherapy-induced nausea-vomiting and is associated with fewer side effects such as lethargy and excessive daytime sleepiness," stated Professor Dr Jyoti Bajpai, the main author of The Lancet Oncology paper. Dr. Bajpai emphasized that patients on the low-dose regimen also required fewer steroids, a crucial factor for cancer patients with comorbidities like diabetes or compromised immune conditions.
In their randomised phase 3 trial, the team studied the effects of olanzapine at low doses versus the standard dosage (10mg) over four days. The trial enrolled 267 patients aged between 13 and 75 years, undergoing anthracycline or high-dose cisplatin-based chemotherapy for solid tumours.
"Our primary objective was to compare the two groups for 'complete control,' defined as no vomiting episodes, no requirement for rescue medications, and no/mild nausea after chemotherapy," explained Dr. Bajpai. The trial, conducted between February 9, 2021, and May 30, 2023, led to the conclusion that the low-dose option had equal efficacy and fewer side effects, reported TOI.
Tata Memorial Centre intends to adopt this new low-dose option for patients undergoing chemotherapy, with doctors emphasizing the potential global impact and improved comfort for a significant number of patients experiencing chemotherapy-induced nausea and vomiting. TMC academic dean Dr. S. D. Banavali concurred, stating, "This low-cost measure has the potential to change global practice and provide comfort to a large number of patients who experience chemotherapy-induced nausea and vomiting."