Fatigue, headache, dry mouth, diarrhea were common
adverse events in two groups but did not result in level 3 or 4 toxicity, which could be tolerated by two groups patients. Most patients in control group had disturbed sleep during chemotherapy which could be relieved by oral estazolam. Discussion Although 5-HT3 receptor antagonists have been particularly effectively for the acute CINV [11–13], they have not effective against the delayed CINV in patients receiving highly or moderately emetogenic chemotherapy . They have the same efficacy as dexamethation Smoothened inhibitor for prevention of the delayed CINV , so this study compared olanzapine regimen with the standard therapy regimen to evaluate their effect for CINV in patients receiving highly or moderately emetogenic chemotherapy. In the present study, the effect of two regimens were similar to the acute nausea and vomiting, but the olanzapine regimen protected more than two-thirds of patients from emesis after they received highly or moderately emetogenic chemotherapy and enabled them to avoid the use of rescue therapy during
2-4 days after chemotherapy, whereas treatment of control group with the currently available standard therapy protected approximately half of patients. The superiority of olanzapine PCI-32765 supplier for control of delayed nausea and vomiting caused by highly emetogenic chemotherapy is more than its roles on delayed nausea and vomiting caused by GNE-0877 moderately emetogenic chemotherapy. In the assessments of complete response over the period after chemotherapy, the olanzapine regimen provided a substantial improvement of 41 and 26 percent points and 22 and 13 percent points over standard therapy in the prevention of nausea and vomiting after highly and moderately emetogenic chemotherapy, this represented a clearly meaningful benefit. Recent studies
demonstrated that the acute emesis is BMS-907351 molecular weight mainly associated with serotonin, so 5-HT3 receptor antagonists have a dramatically effect on the acute emesis in many trials, but delayed emesis seems to differ in its pathogenic mechanism from acute emesis because drugs that are so effective in preventing the acute emesis are less effective in the delayed period such as 5-HT3 receptor antagonist. Olanzapine blocks multiple neurotransmitters which are known mediators of CINV. Olanzapine appears to have activity in control acute and delayed nausea and vomiting. According to CTCAE V3.0, level 1 of nausea means loss of appetite without alteration in eating habits, level 2 means oral intake decreased without significant weight loss, dehydration or malnutrition; IV fluids, indicated < 24 hrs, level 3 means inadequate oral caloric and/or fluid intake, IV fluids, tube feedings, or TPN indicated > = 24 hrs. Level 1 of vomiting means 1 episode in 24 hrs, level 2 means 2-5 episodes in 24 hrs; IV fluids indicated < 24 hrs, level 3 means > = 6 episodes in 24 hrs; IV fluids, or TPN indicated > = 24 hrs.