Steroid-sparing Therapy (Olanzapine) Versus Dexamethasone-based Therapy for Chemotherapy-induced Nausea and Vomiting

Inclusion Criteria: * 18 years and older * confirmed cancer diagnosis * starting cycle 1 of an FDA approved treatment that is categorized as high-emetogenic (nausea and vomiting inducing) chemotherapy per National Comprehensive Cancer Network® guidelines * Eastern Cooperative Oncology Group performance score of 0 or 1 * appropriate renal function * appropriate hepatic function * appropriate hematologic function. Exclusion Criteria: * Patients will be excluded if they experience nausea or vomiting up to 24 hours before chemotherapy, * currently on a glucocorticoid therapy * contraindication to glucocorticoid therapy * taking any medication that has antiemetic properties. * scheduled or planned to receive radiation within one week of or concurrently with chemotherapy * brain metastases.