Just for its action at multiple receptors sites, particularly at the D2 and 5H3 receptors, which appear to be involved in nausea and vomiting, suggest that it has potential antiemetic properties. At first some case reports

shew that olanzapine was effective in reduction nausea in advanced cancer patients with opioid-induced nausea [6, 7]. Another study reported that olanzapine may decrease delayed emesis in 28 cancer patients treated with ABT-263 solubility dmso highly or moderately emetogenic chemotherapy [8]. Then a phase I study made sure the maximum tolerated dose of olanzapine which AZD2014 in vivo is 5 mg per day for the 2 days prior to chemotherapy and 10 mg per day for 7 days postchemotherapy[9]. It had safe and effective selleck kinase inhibitor use for the prevention of delayed emesis in cancer patients receiving moderately to highly emetogenic chemotherapy such as cyclophosphamide, doxorubicin, cisplatin, and/or irinotecan. In a II stage trial of olanzapine[10] in combination

with granisetron and dexamethasone for prevention of CINV, the combination therapy proved to be highly effective in controlling acute and delayed CINV in patients receiving highly and moderately emetogenic chemotherapy. CR for acute period, delayed period in ten patients receiving highly emetogenic chemotherapy is respectively 100% and 80%. Results for moderately emetogenic chemotherapy were similar. In order to reduce the side effect of dexamethasone, Navari designed a II stage trial to determine the control of acute and delayed CINV in patients receiving moderately and Fludarabine in vivo highly emetogenic chemotherapy with the combined use of palonosetron, olanzapine and dexamehthasone which was given on day 1 only. For the first cycle of chemotherapy, the complete response (no emesis, no rescue) for the acute, delayed and overall period was respectively 100%, 75%, and 75% in 8 patients receiving HEC and 97%, 75%, and 72% in 32 patients receiving MEC. Patients with no nausea for the acute, delayed, and overall period was respectively 100%, 50% and 50% in 8 patients receiving HEC and was 100%,78%, and 78% in 32 patients receiving MEC. The result shew that

olanzapine combined with a single dose of dexamethasone and a single dose of palonosetron was very effective in controlling acute and delayed CINV in patients receiving both HEC and MEC. Based on these data, olanzapine appear to be a safe and effective agent for prevention acute and delayed CINV in spite of a few of patients. At present the antiemetic regimen is the combination of 5-HT3 receptor antagonist, dexamethasone and/or metoclopramide, diazepam in China. In an attempt to improve the complete remission of the acute and delayed emesis, we preformed a study used with the combination of olanzapine, azasetron and dexamethasone for prevention acute and delayed nausea and vomiting induced by highly or moderately emetogenic chemotherapy.