Abstract:
Objective To compare the effectiveness, safety and cost-effectiveness ratio between Olanzapine (OLN) and Aprepitant (APR) for the prevention of chemotherapy-induced nausea and vomiting (CINV) in female patients who received multi-day cisplatin-based chemotherapy.
Methods Eighty-seven female patients were randomized to receive Aprepitant (44 cases) or Olanzapine (43 cases). Antiemetic regimen received by Aprepitant group and olzanpine group were as follows. Aprepitant group: Aprepitant, Tropisetron and Dexamethasone; Olanzapine group: Olanzapine, Tropisetron and Dexamethasone.
Results No substantial difference was found in complete response rate of delayed emesis in Aprepitant group (29/44) and in Olanzapine group (30/43), (65.9% vs. 69.8%, P=0.690). Higher hiccup incidence was found in Aprepitant group (31.8%, P=0.023) while a more pronounced drowsiness effect was observed in Olanzapine group (25.6%, P=0.006). Hematological toxicity between the two groups was of no significant difference. Yet, the cost of Aprepitant group per cycle was much higher than that of Olanzapine group (P < 0.01).
Conclusion In female lung and breast cancer patients, the safety and effectiveness of Aprepitant combined with Dexamethasone and Tropisetron are similar to those of Olanzapine regarding delayed nausea and vomiting induced by 3 days Cisplatin chemotherapy, but the latter is more cost-effective.
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