Every year, nearly 3,000 Americans are diagnosed with some form of mesothelioma, a cancer of the lining of the lung, heart or abdomen, caused by exposure to asbestos. Mesothelioma is extremely aggressive and is one of the most difficult types of cancer to treat. An equally aggressive chemotherapy regimen is often prescribed to battle the cancer, but the side effects from the toxic amounts of medicine used often leave patients weak and dehydrated. Now, researchers report they may have found a drug to effectively treat these chemo-induced side effects.
A team of researchers, led by oncologist and cancer researcher Steven Powell, M.D., of Sanford Health, a health system headquartered in the Dakotas, have found that an off-label use of the drug olanzapine, FDA approved for use as an anti-psychotic agent, “significantly improved nausea prevention” in patients undergoing chemotherapy treatment.
“We’ve long known the nausea and vomiting that come along with chemotherapy are a major problem and affect the quality of life of our patients,” said Dr. Powell in a July 19 University of South Dakota press release. “The findings of this study, fortunately, provide physicians with a tool to better address the needs of those they are treating for cancer.”
Vomiting (medically known as emesis) and nausea from chemotherapy treatments can significantly impact a patient’s quality of life and may even lead them to halt their chemo treatments. While currently, doctors can prescribe a variety of anti-emetic medications, including aprepitant (Emend®), dolasetron (Anzemet®), granisetron (Kytril®), ondansetron (Zofran®), lorazepam (Ativan®), metoclopramide (Reglan®), to minimize the sickness, many patients are still affected with some amount of vomiting.
In the study of 380 patients, with half receiving olanzapine and the other half given a placebo, 74 percent of the olanzapine patients had no chemotherapy-induced nausea within the first 24 hours after treatment, compared to 45 percent of the placebo patients. The researchers found that the benefits of using olanzapine continued for five days after chemotherapy treatment.
In 2012, researchers at Harper Cancer Institute at Indiana University reported similar results in a study of 38 patients. Then ASCO president-elect Dr. Sandra M. Swain, a breast cancer expert, said at the time, “This is a huge advance,” and “a great step forward for quality of life for our patients.”
These findings are especially important for mesothelioma patients who are undergoing chemotherapy using the doublet or triplet standard of care of cisplatin/pemetrexed or bevacizumab with pemetrexed/cisplatin, respectively. According to the American Society of Clinical Oncology, cisplatin has a “high risk” of causing nausea and vomiting. The other two drugs have a low or minimal risk.
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Mesothelioma patients are encouraged to partner with their doctors and to provide timely feedback regarding side effects and any treatment concerns to ensure the best of quality of life while battling the cancer.
The study can be found in the July 14 issue of the New England Journal of Medicine.