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A Comparative Study of the Efficacy and Safety of Olanzapine and Aprepitant Regimens in Highly Emetogenic Chemotherapy

M Prasad, Ananya Chakraborty and Shashidhar VK

Aim: To compare the efficacy and safety of Olanzapine and aprepitant regimens in highly emetogenic Chemotherapy (HEC).
Materials and methods: A randomized, prospective study was conducted in tertiary care hospital, Bangalore. 84 participants were randomized into two groups. Group A (OPD) received on Day 1 (30 mins prior to chemotherapy):Tab Olanzapine 10 mg p/o, Inj Palonosetron 0.25 mg i.v. and Inj Dexamethasone 20 mg i.v. and on Day 2-Day 4: Tab Olanzapine 10 mg p/o once daily. Group B (APD) received on Day 1 (30 mins prior to chemotherapy): Tab Aprepitant 125 mg p/o, Inj Palonosetron 0.25 mg iv and Inj. Dexamethasone 12 mg i.v. on Day 2-Day 3: Tab Aprepitant 80 mg p/o once daily and Tab Dexamethasone 8 mg p/o once daily, on Day 4: Tab Dexamethasone 8 mg p/o once daily.
Results: In OPD group CR was seen in 88%, 86% and 78% in acute (0-24 hrs), delayed (24-120 hrs) and overall period (0-120 hrs) respectively. In APD group CR was seen in 86%, 83% and 70% in acute, delayed and overall period respectively. Adverse drug reactions (ADR's) were seen in total of 12 participants, 6 in each group, there were no significant grade 3 or 4 toxicities. In OPD group Average FLIE scores on day 1 and day 6 were 30.34 and 32.47 respectively while in APD group it was 32.47 and 39.18 respectively.
Conclusion: Both APD and OPD regimens were comparable in controlling CINV in acute and delayed period. OPD regimen was better in overall period and had less impact on QOL compared to APD regimen.