Efficacy and Safety of 5 mg Olanzapine for Nausea and Vomiting Management in Cancer Patients Receiving Carboplatin: Integrated Study of Three Prospective Multicenter Phase II Trials

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2021 Jul 20

PMID 34281514

Citations 2

Authors

Senri Yamamoto

Hirotoshi Iihara

Ryuji Uozumi

Hitoshi Kawazoe

Kazuki Tanaka

Yukiyoshi Fujita

Masakazu Abe

Hisao Imai

Masato Karayama

Yoh Hayasaki

Chiemi Hirose

Takafumi Suda

Kazuto Nakamura

Akio Suzuki

Yasushi Ohno

Ken-Ichirou Morishige

Naoki Inui

Affiliations

Soon will be listed here.

Abstract

Background: The efficacy of olanzapine as an antiemetic agent in cancer chemotherapy has been demonstrated. However, few high-quality reports are available on the evaluation of olanzapine's efficacy and safety at a low dose of 5 mg among patients treated with carboplatin regimens. Therefore, in this study, we investigated the efficacy and safety of 5 mg olanzapine for managing nausea and vomiting in cancer patients receiving carboplatin regimens and identified patient-related risk factors for carboplatin regimen-induced nausea and vomiting treated with 5 mg olanzapine.

Methods: Data were pooled for 140 patients from three multicenter, prospective, single-arm, open-label phase II studies evaluating the efficacy and safety of olanzapine for managing nausea and vomiting induced by carboplatin-based chemotherapy. Multivariable logistic regression analyses were performed to determine the patient-related risk factors.

Results: Regarding the endpoints of carboplatin regimen-induced nausea and vomiting control, the complete response, complete control, and total control rates during the overall study period were 87.9, 86.4, and 72.9%, respectively. No treatment-related adverse events of grade 3 or higher were observed. The multivariable logistic regression models revealed that only younger age was significantly associated with an increased risk of non-total control. Surprisingly, there was no significant difference in CINV control between the patients treated with or without neurokinin-1 receptor antagonist.

Conclusions: The findings suggest that antiemetic regimens containing low-dose (5 mg) olanzapine could be effective and safe for patients receiving carboplatin-based chemotherapy.

Citing Articles

MASCC antiemetic consensus recommendations: resource-limited settings.

Bosnjak S, Zilic A, Radhakrishnan V, Ostwal V, Aapro M, Iihara H Support Care Cancer. 2025; 33(3):181.

PMID: 39937269 DOI: 10.1007/s00520-025-09211-4.

2020 ASCO, 2023 NCCN, 2023 MASCC/ESMO, and 2019 CCO: a comparison of antiemetic guidelines for the treatment of chemotherapy-induced nausea and vomiting in cancer patients.

Kennedy S, Goodall S, Lee S, DeAngelis C, Jocko A, Charbonneau F Support Care Cancer. 2024; 32(5):280.

PMID: 38594320 DOI: 10.1007/s00520-024-08462-x.

Effects of adding a neurokinin-1 receptor antagonist to 5 mg olanzapine, a 5-hydroxytryptamine-3 receptor antagonist, and dexamethasone for preventing carboplatin-induced nausea and vomiting: a propensity score-matched analysis.

Yamamoto S, Iihara H, Uozumi R, Kawazoe H, Tanaka K, Fujita Y BMC Cancer. 2022; 22(1):310.

PMID: 35321690 PMC: 8941806. DOI: 10.1186/s12885-022-09392-9.

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