Chemotherapy Induced Nausea and Vomiting Clinical Trial
Official title:
A Pilot Study Comparing Olanzapine and Aprepitant for the Prevention of Chemotherapy Induced Nausea and Vomiting in Pediatric Patients Receiving Highly Emetogenic Chemotherapy
The purpose of this study is to determine the feasibility of a larger trial comparing olanzapine and aprepitant and to obtain preliminary data on the effectiveness of these two medications to treat nausea and vomiting in children receiving chemotherapy. Children receiving 2 cycles of chemotherapy with a high risk of causing nausea and vomiting will receive olanzapine in one cycle and aprepitant in another cycle. Children will be randomized to see which medicine they receive first. The investigators will record the number of extra medications used for nausea, the number of times a child vomits, and the amount of nausea the child feels each day.
This will be a pilot study, designed as a randomized, crossover study comparing olanzapine
and aprepitant in pediatric oncology patients receiving highly emetogenic chemotherapy
(HEC). The primary objective is to determine the feasibility of recruitment and data
collection for conducting a larger trial aimed at comparing olanzapine and aprepitant as
antiemetic regimens and establishing efficacy of this regimens for pediatric patients
receiving HEC. Secondary objectives are to obtain preliminary data regarding the
effectiveness of olanzapine and aprepitant as well as the tolerability of olanzapine in the
pediatric oncology population.
Each patient must be planned to undergo at least 2 cycles of the same cycle of HEC. Each
patient will be randomized to receive olanzapine or aprepitant in the first cycle of
chemotherapy, and then will receive the other agent in a second cycle of chemotherapy.
Patients will also receive ondansetron and dexamethasone with each cycle. Patients with CNS
tumors will not receive dexamethasone. Response will be measured objectively recording
number of emesis and use of breakthrough medications. The medications chosen for
breakthrough medications will be at the treating physicians discretion. A complete response
will be no episodes of emesis or use of breakthrough medications. A partial response is one
or less episodes of emesis and one or less use of breakthrough medications. Nausea will be
measured based on parent and patient scales and will be a separate measure, not included in
the compete or partial response.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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