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

• Published in: BMC Cancer
• Main 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
• Format: Article
• Language: English
• Published: BMC 2021-07-01
• Subjects: Antiemetics; Carboplatin; Nausea; Olanzapine; Vomiting
• Online Access: https://doi.org/10.1186/s12885-021-08572-3

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.