Olanzapine versus fosaprepitant for the prevention of concurrent chemotherapy radiotherapy-induced nausea and vomiting

Navari, Rudolph M.; Nagy, Cindy K; Le‐Rademacher, Jennifer; Loprinzi, Charles L.

doi:10.12788/jcso.0245

Cited by 36 publications

(42 citation statements)

References 24 publications

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“…Finally, 13 RCTs published between 2009 and 2016 fulfilling the inclusion criteria were included in the final quantitative analyses 20-32. The sample size of the included trials ranged from1723 to 38032 with a total number of 1686 patients, of which 852 were assigned to the olanzapine regimen and 834 to standard regimen without olanzapine (non-olanzapine).…”

Section: Resultsmentioning

confidence: 99%

“…Many randomized controlled trials (RCTs) have been then conducted to confirm the effect of addition of olanzapine to the standard antiemetic regimen 20,21,22,23,24,25,26,27,28,29,30,31,32. A previous meta-analysis conducted by Wang et al33 revealed that the rate of patients achieving total control of nausea and vomiting was significantly higher in the olanzapine group.…”

Section: Introductionmentioning

confidence: 99%

“…After the publication of meta-analysis by Chiu et al34, the largest RCT so far done in this area included 380 patients 32. In addition, other small RCTs were also published elsewhere 20,31…”

Section: Introductionmentioning

confidence: 99%

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Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis

Chelkeba¹,

Gidey²,

Mamo³

et al. 2017

Pharm Pract (Granada)

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Background:Chemotherapy induced nausea and vomiting (CINV) remains the most distressing event in patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC).Objective:Therefore, this meta-analysis was conducted to evaluate the efficacy of olanzapine containing regimen in preventing acute, delayed and overall phases of CINV.Methods:PubMed, EBSCO, and Cochrane central register of controlled trials electronic databases were searched to identify RCTs that compared the effects of olanzapine with non-olanzapine regimen in preventing CINV. Randomized clinical trials (RCTs) that compared olanzapine containing regimen with non-olanzapine regimen were included. The primary outcomes were the percentage of patients achieving no vomiting or no nausea in acute, delayed and overall phases.Results:13 RCTs that enrolled 1686 participants were included in this meta-analysis. 852 patients were assigned to olanzapine and 834 patients were assigned to non-olanzapine regimen (other standard antiemetic regimen). The percentages of no emesis achieved were 87.5%, 76.2%, 73.6% in olanzapine versus 76.7%, 61.8%, and 56.4% in non-olanzapine regimen in acute, delayed and overall phases, respectively. The percentages of no nausea were 82%, 64.3%, 61.6% in olanzapine group versus 71.3%, 41.8%, and 40.6% in non-olanzapine group in acute, delayed and overall phases, respectively. In general, olanzapine containing regimen achieved statistical superiority to non-olanzapine regimen in no vomiting endpoint in acute phase (OR 2.16; 95%CI 1.60 to 2.91, p<0.00001; I-square=5%; p=0.40), delayed phase (OR 2.28; 95%CI 1.1.46 to 3.54, p=0.0003; I-square=65%; p=0.001) and overall phase (OR 2.48; 95%CI 1.59 to 3.86, p<0.0001; I-square=69%; p< 0.0001).Conclusion:The current meta-analysis showed that olanzapine was statistically and clinically superior to non-olanzapine regimen in preventing CINV in most domains of the parameters.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis

Chelkeba¹,

Gidey²,

Mamo³

et al. 2017

Pharm Pract (Granada)

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“…One of the randomised studies (n = 40) was impaired by methodological pitfals [23], and two others included 14 -101 patients only [25,26]. This means that these studies contribute to guideline recommendations with level III -IV evidence.…”

Section: Resultsmentioning

confidence: 99%

“…Olanzapine 10 mg has recently been compared to fosaprepitant in a small phase III study in patients receiving chemo-radiotherapy (only the first cycle evaluated), and nausea was significantly better prevented in the delayed phase with olanzapine compared to fosaprepitant [26]. These are interesting results, as effective drugs against chemotherapy-and/or radiotherapy-induced nausea are warranted.…”

Section: Expert Opinionmentioning

confidence: 99%

New treatments on the horizon for chemoradiotherapy-induced nausea and vomiting

Ruhlmann

Herrstedt

2016

Expert Opinion on Pharmacotherapy

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Antiemetic prophylaxis for patients receiving concomitant chemoradiotherapy has, for many years, been an orphan research area. The distinction between acute and delayed nausea and vomiting does not apply to fractionated radiotherapy, and prophylaxis should be considered to cover the entire course of treatment and not only the acute and delayed chemotherapy-induced nausea and vomiting. The best prophylaxis in women receiving fractionated radiotherapy and concomitant weekly cisplatin is a combination of the neurokinin receptor antagonist fosaprepitant with palonosetron and dexamethasone. Even with this three-drug combination nausea is a significant problem and the effect of multi-receptor targeting antiemetics such as olanzapine and amisulpride should be explored in this setting.

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Olanzapine for the prevention and treatment of cancer-related nausea and vomiting in adults

Sutherland

Naessens²,

Plugge

et al. 2018

Cochrane Database of Systematic Reviews

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Olanzapine versus fosaprepitant for the prevention of concurrent chemotherapy radiotherapy-induced nausea and vomiting

Cited by 36 publications

References 24 publications

Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis

Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis

New treatments on the horizon for chemoradiotherapy-induced nausea and vomiting

Olanzapine for the prevention and treatment of cancer-related nausea and vomiting in adults

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