Effects of 5-mg dose of olanzapine for breakthrough nausea and vomiting in patients receiving carboplatin-based chemotherapy: a prospective trial

Maeda, Akimitsu; Yoshida, Hiroki; Inoue, Hirotaka; Ejiri, Masayuki; Yamaguchi, Satoe; Kushihara, Hideyuki; Yamamoto, Yoshihiro; Ando, Yosuke; Sato, Yumiko; Tashiro, Yuusuke; Hasegawa, Ayako; Takahara, Yuko; Mizutani, Mika; Oze, Isao; Shimizu, Junichi

doi:10.21037/apm-20-1784

Cited by 1 publication

(1 citation statement)

References 14 publications

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“…A single-arm, prospective trial analyzed the total control (no emesis, no nausea, no rescue medications) (primary endpoint) and early efficacy using the nausea scores at 30, 60, and 120 min after taking olanzapine (secondary endpoint) in 19 patients who took olanzapine (5 mg daily for 3 days) for breakthrough CINV after carboplatin-based therapy [ 16 ]. Even though nausea was significantly reduced after 30 min ( p = 0.0078), and the scale had been reduced by 67% from the baseline after 60 min, the olanzapine 5 mg did not show the expected effect on the complete disappearance of CINV within 24 h. The main methodological problems with this study are the endpoints that were not validated, as well as the phase II study design.…”

Section: Resultsmentioning

confidence: 99%

2023 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following multiple-day chemotherapy, high-dose chemotherapy, and breakthrough nausea and vomiting

Rapoport,

Herrstedt,

Snow

et al. 2023

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Purpose This review is an update of the MASCC/ESMO 2015 recommendations for the prophylaxis of acute and delayed nausea and vomiting induced by multiple-day chemotherapy, high-dose chemotherapy, and breakthrough nausea and vomiting. Methods A systematic literature search was conducted using PubMed from June 1, 2015, through February 1, 2023. Results We identified 56 references (16 were duplications or invalid), leaving 40 manuscripts for this search. The panel classified level I evidence (three manuscripts) and level II evidence (14 manuscripts). High-dose chemotherapy and stem cell transplant were discussed in four of these manuscripts, and multiple-day chemotherapy treatment in 15. Some manuscripts covered both topics. Additionally, a search for breakthrough nausea and vomiting resulted in 12 “hits.” No new relevant studies were identified. Conclusions The recommendations for patients receiving high-dose chemotherapy with stem cell transplants and patients undergoing multiple-day cisplatin were updated. For patients receiving high-dose chemotherapy for stem cell transplant, a combination of a 5-HT3 receptor antagonist with dexamethasone and aprepitant is recommended. Olanzapine could be considered part of the antiemetic regimen. Patients receiving multiple-day cisplatin should receive a 5-HT3 receptor antagonist plus dexamethasone plus aprepitant plus olanzapine. For patients experiencing breakthrough nausea and vomiting, the available evidence suggests using a single dose of olanzapine daily for 3 days.

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Section: Resultsmentioning

confidence: 99%