Olanzapine is more efficacious than other standard antiemetics for the rescue of chemotherapy-induced nausea and vomiting (CINV) and including it in an antiemetic regimen improves control in the prevention setting, according to a study published online ahead of print in the journal Supportive Care in Cancer.1

Olanzapine is an atypical antipsychotic approved by the US Food and Drug Administration for the treatment of schizophrenia and bipolar disorder. It has also been investigated for use as an antiemetic in both the prevention and rescue setting of CINV, specifically in combination with palonosetron and dexamethasone.

Therefore, researchers sought to systematically review the efficacy of olanzapine in comparison with other antiemetics for the prophylaxis and rescue of CINV.

For the study, researchers analyzed data from 10 randomized, controlled trials that evaluated olanzapine in the preventative setting and 3 randomized controlled trials that assessed the drug in the breakthrough setting.

Results showed that in the prophylaxis setting, olanzapine was statistically superior in 5 of 6 end points and clinically superior in 4 of 6 end points. Researchers found that olanzapine was statistically and clinically superior in the breakthrough setting.

In addition, a subgroup analysis demonstrated a similar benefit from the 5 mg dose and the 10 mg dose of olanzapine for preventing emesis in the overall phase, suggesting that the 5 mg dose should be considered to potentially reduce adverse events.

REFERENCE

1. Chiu L, Chow R, Popovic M, et al. Efficacy of olanzapine for the prophylaxis and rescue of chemotherapy-induced nausea and vomiting (CINV): a systematic review and meta-analysis [published online ahead of print January 15, 2016]. Supp Care Cancer. doi:10.1007/s00520-0163075-8.

2. Navari RM, Einhorn LH, Loehrer PJ, et al. A phase II trial of olanzapine, dexamethasone, and palonosetron for the prevention of chemotherapy-induced nausea and vomiting: A Hoosier oncology group study. Supp Care Cancer. 2007;15(11):1285-1291.