Short summary

• DANSAC-EPI: Epidemiologic study to determine the prevalence of nausea and the effect of current treatment (around 1500 patients screened).
• DANSAC-RCT: A double blinded, randomized, controlled trial of a NK1-receptor antagonist vs placebo (75 patients).
• DANSAC-OPEN: An open label study of olanzapine 10 mg daily for 5 consecutive days (40 patients).

Rationale

Nausea and vomiting (N/V) are among the worst symptoms in patients with advanced cancer. The risk of N/V depends on several factors and is in the literature described to vary between 6-68 % in these patients. Despite continuing progress in the treatment of chemotherapy-induced nausea and vomiting during the last 30 years, the incidence and severity of N/V are roughly unchanged in patients with advanced cancer receiving palliative care. Evidence regarding the effect of antiemetic treatment for cancer patients in palliative care is sparse. The most recently published reviews conclude that no guidelines can be established based on the present level of evidence, and that new research is urgently needed.

In summary, the burden of N/V is very significant and N/V can, if untreated, lead to rapid deterioration in this old and fragile group of patients. The evidence base for treatment is minimal. Research in the treatment of N/V in palliative care therefore seems highly warranted, and these studies will have the potential to create important new knowledge.

Description of the cohort

Recruited from home, hospice or hospital, 5 Danish departments.

Primary criteria:

Advanced cancer with no curable treatment options

Age 18 years or more

Ability to read and understand the forms required for the study

Life-expectancy more than 2 weeks

No abdominal or brain surgery within the last 2 weeks or exposure to general anesthesia within the last 4 days.

No chemotherapy or radiation therapy within the last 4 weeks

Data and biological material

Data originating from questionnaires and medical records. No biological material.

Collaborating researchers and departments

Bispebjerg Hospital

Zealand University Hospital

Department of Palliative Care, Zealand University Hospital

Aarhus University Hospital

Sydvestjysk Sygehus, Esbjerg

Publications associated with the project