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Sanford clinical trial results in new drug to stop vomiting in chemotherapy

SIOUX FALLS -- A new drug is now available that can reduce nausea and vomiting caused by chemotherapy -- thanks to a national clinical trial that included Sanford Health sites in Sioux Falls, Fargo, Bismarck, N.D., and Bemidji, Minn.

Sanford oncologist and cancer researcher Dr. Steven Powell of Sioux Falls was a leader in the study that used the drug olanzapine and found that 75 percent of the 192 patients in the study had no nausea after taking one pill for four days after a chemotherapy treatment.

“That’s huge,” said Powell in an interview Wednesday after the finding was published in the New England Journal of Medicine this week.

By being published in the prestigious journal, Powell said this new treatment “is now the standard” for doctors to use with cancer patients.

“We’ve long known that nausea and vomiting that come along with chemotherapy are a major problem and affect the quality of life of our patients,” Powell said. “That’s what most of our patients ask and are worried about, ‘Am I going to get sick?’”

“That’s not pleasant,” he said.

Besides cutting that risk with the new pill, the other good news, said Powell, is the cost.

The pills, an FDA-approved antipsychotic agent most often used to treat people with schizophrenia, are only 50 cents per pill.

The reason is that it’s generic.

Powell said it’s being phased out for treatment of mental illness because of the weight gain often associated with its use. He said it will now be “re-purposed’ for the treatment of nausea for cancer patients.

As for side effects, increased appetite was one  -- kind of expected -- but of course a benefit as doctors often are encouraging patients to eat more while undergoing chemotherapy, Powell said.

The other was “increased sedation” or being sleepy for about a day after taking the pill.

“But that was resolved in patients after about two days,” Powell said.

When asked about what some people might think about using antipsychotic drugs, Powell said when they explain the biology of the pill --  that it blocks neurotransmitters in the brain involved with nausea and vomiting -- and that it’s safe, patients seem to understand.

“There’s often a stigma with a lot of drugs,” Powell said.

Powell, who was born and raised in Vermillion, S.D., and returned to the region three years ago, said 22 oncologists in the Sanford Health system participated in the study -- which was also led by cancer researchers at Indiana University School of Medicine in South Bend and the Mayo Clinic in Rochester, Minn., and supported by grants from the National Cancer Institute.

Most of the patients in the clinical trial were women being treated for breast cancer, while the other group was people with head and neck cancers -- all at high risk for nausea and vomiting.

Powell estimated that about 20 patients were included in the trial from the Sanford clinics. Besides the 186 taking the pills, another 188 were given a placebo.

Powell also is designing and overseeing other clinical research studies involving immunotherapy and targeted medicine for cancer care.

He would like to get more patients in the region involved in cancer studies, he said, so they can benefit from advancements being made in treating cancer.

“The biggest breakthroughs come through these clinical trials,” Powell said.