Olanzapine-containing antiemetic therapy for the prevention of carboplatin-induced nausea and vomiting

• Published in: Cancer chemotherapy and pharmacology Vol. 84; no. 1; pp. 147 - 153
• Main Authors: Tanaka, Kazuki, Inui, Naoki, Karayama, Masato, Yasui, Hideki, Hozumi, Hironao, Suzuki, Yuzo, Furuhashi, Kazuki, Fujisawa, Tomoyuki, Enomoto, Noriyuki, Nakamura, Yutaro, Kusagaya, Hideki, Matsuura, Shun, Uto, Tomohiro, Hashimoto, Dai, Matsui, Takashi, Asada, Kazuhiro, Suda, Takafumi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2019; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Antiemetics; Antiemetics - administration & dosage; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Antipsychotics; Aprepitant - administration & dosage; Cancer Research; Carboplatin; Carboplatin - administration & dosage; Carboplatin - adverse effects; Chemotherapy; Confidence intervals; Dexamethasone; Dexamethasone - administration & dosage; Drug Therapy, Combination; Female; Humans; Lung cancer; Lung Neoplasms - drug therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Nausea; Nausea - chemically induced; Nausea - prevention & control; Neurokinin; Neurokinin NK1 receptors; Neurotransmitter receptors; Olanzapine; Olanzapine - administration & dosage; Oncology; Original Article; Pharmacology/Toxicology; Phase control; Prevention; Prospective Studies; Receiving; Receptors; Response rates; Serotonin; Serotonin S3 receptors; Vomiting; Vomiting - chemically induced; Vomiting - prevention & control; Carboplatin; Olanzapine; Antiemetic; Chemotherapy-induced nausea and vomiting
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/s00280-019-03868-5

Purpose There remains an unmet clinical need for the control of chemotherapy-induced nausea and vomiting (CINV), particularly in the prevention of nausea and the delayed phase control. We evaluated the efficacy and safety of antiemetic therapy with olanzapine, a neurokinin-1 receptor antagonist, a 5-hydroxytryptamine-3 (5-HT 3 ) receptor antagonist and dexamethasone in patients receiving carboplatin-containing chemotherapy. Olanzapine inhibits signalling via multiple neurotransmitter receptors involved in CINV. Methods Chemotherapy-naïve patients with lung cancer who received carboplatin-containing chemotherapy were enrolled in this phase-II study. Patients received olanzapine, aprepitant, a 5-HT 3 receptor antagonist and dexamethasone. The primary endpoint was the complete response rate (no vomiting and no rescue therapy) during 120 h after administration of chemotherapy agents. Results Thirty-three patients received olanzapine-containing antiemetic therapy. The overall complete response rate was 93.3% (95% confidence interval, 80.4–98.3%). The frequency of nausea was 15.2% in the delayed phase and 18.2% in the overall phase. Somnolence was observed in 16 patients. Conclusion Adding olanzapine to antiemetic therapy with aprepitant, a 5-HT 3 receptor antagonist and dexamethasone improved CINV control in patients receiving carboplatin-containing chemotherapy.