Retrospective review of the antiemetic activity and anti-mental disorder of olanzapine in Soft- tissue sarcoma and Osteosarcoma patients with high-dose chemotherapy

Abstract

Abstract Purpose: The aim of the study was to evaluate the role of olanzapine, which is an atypical antipsychotic drug, in antiemetic activity and anti-depression in soft-tissue sarcoma and osteosarcoma patients receiving high-dose chemotherapy. Methods: The retrospective observational study was performed at Shanghai Jiao Tong University Affiliated Sixth People's Hospital between 2017.1–2020.5 to observe the efficacy and safety of olanzapine combined with aprepitant,5-HT3 receptor antagonists and dexamethasone. We retrospectively reviewed the clinical records of soft-tissue sarcoma and osteosarcoma patients received highly emetogenic chemotherapy regimen, which containing cisplatin (75-100 mg/m2), doxorubicin regimen(60-75mg/ m2) or high-dose ifosfamide(8-12g/ m2). All included patients were more than 18 years old, with no history of drinking.140 patients were included in this study. These patients were assigned into two groups for olanzapine-containing therapy and non-olanzapine dual therapy. All patients received aprepitant,5-HT3 receptor antagonists and dexamethasone and in olanzapine group olanzapine was administered orally at 5mg/d from day1 to day 5. The study outcomes were complete response (CR), mental state evaluated by SAS and SDS, and quality of life (QoL) by the functional living index-emesis (FLIE) questionnaire. Results: The complete response (CR) rate in the olanzapine group was significantly higher than in the control group in delayed and overall phase (74.3% vs 47.1%, p=0.002; 67.1% vs 44.3%,p=0.010). No significant difference CR in acute phase was observed between the two groups. Meanwhile, the mental disorder including anxiety and depression in olanzapine group was ameliorated significantly (P<0.05). The patients in olanzapine group exhibited higher FLIE scores, which demonstrated better quality of life. More patients in the olanzapine group exhibited somnolence, constipation and fatigue. Conclusions: Olanzapine is safe and effective in preventing high-dose chemotherapy-induced nausea and vomiting and decreasing anxiety and depression in soft-tissue sarcoma and osteosarcoma patients. Meanwhile, patients in olanzapine group exhibit better QoL compared to non-olanzapine group. Further randomized studies are required to confirm these results.