(173) Olanzapine for Primary Prophylaxis of Chemotherapy-Induced Nausea and Vomiting in Autologous Stem Cell Transplant

Poster Abstract:

Background: Chemotherapy-induced nausea and vomiting (CINV) is a toxicity significantly impacting patients receiving cancer treatment. This toxicity may result in dehydration, metabolic derangements, malnutrition, decreased quality of life, and discontinuation of cancer treatment. Therefore, it is imperative to provide antiemetic regimens to prevent CINV. Optimizing the prophylactic antiemetic regimen while following ASCO/NCCN guidelines to avoid toxicities is particularly important for patients during the autologous stem cell transplant (ASCT) process. Previous studies have shown olanzapine to be effective in the treatment of breakthrough and refractory CINV in patients treated with high-dose, multiple day chemotherapy prior to ASCT. These findings led to the integration of olanzapine into the prophylactic regimen for this patient population in early 2023. However, there is limited evidence for the use of olanzapine for CINV prophylaxis in ASCT. This study seeks to fill that gap in knowledge.

Objective: To determine if the addition of olanzapine to CINV prophylaxis in ASCT has decreased rates of breakthrough CINV

Methods: This single-center, retrospective, matched cohort study included patients ≥19 years of age who had received ASCT between November 1, 2017 and November 22, 2023 at Nebraska Medicine. Patients were matched based on chemotherapy regimen, sex, and age within 5 years in a 1:2 ratio for CINV prophylaxis with olanzapine versus no olanzapine prophylaxis. The primary outcome of breakthrough CINV was defined as documented emesis episodes and/or use of rescue antiemetics from transplant day 0 to patient discharge.

Results: Results pending.

Discussion/

Conclusions: This retrospective study seeks to optimize the antiemetic regimen for patients receiving autologous stem cell transplants. The study hopes to expand on evidence for the prophylactic use of olanzapine.

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