Advertisement

Supportive Care in Cancer

, Volume 24, Issue 2, pp 1001–1008 | Cite as

Efficacy and safety of olanzapine for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV) as reported in phase I and II studies: a systematic review

  • Ronald Chow
  • Leonard Chiu
  • Rudolph Navari
  • Steven Passik
  • Nicholas Chiu
  • Marko Popovic
  • Henry Lam
  • Mark Pasetka
  • Edward ChowEmail author
  • Carlo DeAngelis
Review Article

Abstract

Introduction

Olanzapine is an atypical antipsychotic drug that inhibits serotonergic, dopaminergic, alpha-1 adrenergic, histaminic, and muscarinic receptors. Several phase I and II trials have been published documenting the use of olanzapine in controlling chemotherapy-induced nausea and vomiting (CINV). This review aims to summarize all phase I and II trials that reported on olanzapine for the prophylaxis of CINV.

Methods

A literature search was conducted in Ovid MEDLINE from 1946 to July week 1 2015, Embase Classic and Embase from 1947 to 2015 week 28, and the Cochrane Central Register of Controlled Trials up until June 2015. Phase I and II trials reporting on olanzapine for the prophylaxis for CINV were included if they reported on at least one of four primary endpoints: complete response (CR), complete control (CC), no nausea, and no emesis. Other endpoints of interest included the safety of olanzapine as measured by the M.D. Anderson Symptom Inventory.

Results

Across the seven included studies, there were a total of 201 patients. The CR across four studies was 97.2, 83.1, and 82.8 % for the acute, delayed, and overall phases, respectively. The CC for acute, delayed, and overall phases was 92.5, 87.5, and 82.5 %, respectively. The overall no nausea rate was 92.7, 71.8, and 70.6 % for the acute, delayed, and overall phases, respectively. The overall no emesis rates for the acute, delayed, and overall phases were 100, 94.5, and 90.4 %, respectively. Fatigue, drowsiness, and disturbed sleep were common side effects.

Conclusion

Olanzapine is efficacious and safe when used as a prophylaxis for CINV.

Keywords

Olanzapine Chemotherapy-induced nausea and vomiting Prophylaxis Efficacy Safety 

Notes

Acknowledgments

We thank the generous support of Bratty Family Fund, Michael and Karyn Goldstein Cancer Research Fund, Joey and Mary Furfari Cancer Research Fund, Pulenzas Cancer Research Fund, Joseph and Silvana Melara Cancer Research Fund, and Ofelia Cancer Research Fund.

Compliance with ethical standards

Conflict of interest

None

References

  1. 1.
    Osoba D, Zee B, Warr D, Latreille J, Kaizer L, Pater J (1997) Effect of postchemotherapy nausea and vomiting on health-related quality of life. Support Care Cancer 5(4):307–313PubMedCrossRefGoogle Scholar
  2. 2.
    Bymaster FP, Calligaro D, Falcone J, Marsh R, Moore N, Tye N et al (1996) Radio-receptor binding profile of the atypical antipsychotic olanzapine. Neuropsychopharmacology 14:87–96PubMedCrossRefGoogle Scholar
  3. 3.
    Srivastava M, Brito-Dellan N, Davis MP, Leach M, Lagman R (2003) Olanzapine as an antiemetic in refractory nausea and vomiting in advanced cancer. J Pain Symptom Manage 25(6):578–582PubMedCrossRefGoogle Scholar
  4. 4.
    Pirl WF, Roth AJ (2000) Remission of chemotherapy-induced emesis with concurrent olanzapine treatment: a case report. Psychooncology 9:84–87PubMedCrossRefGoogle Scholar
  5. 5.
    Abe M, Hirashima Y, Kasamatsu Y, Kado N, Komeda S, Kuji S et al. (2015) Efficacy and safety of olanzapine combined with aprepitant, palonosetron and dexamethasone for preventing nausea and vomiting by cisplatin-based chemotherapy in gynecological cancer: KCOG-G1303 phase II trial. Supp Care Canc. doi: 10.1007/s00520-015-2829-z
  6. 6.
    Park S, Choi C, Kwon M, Tae J, Kim H (2015) A phase II trial of palonosetron and olanzapine without dexamethasone for the prevention of chemotherapy-induced nausea and vomiting. Supp Care Canc 23(Suppl 1):S147Google Scholar
  7. 7.
    Navari R, Einhorn L, Passik S, Loehrer P, Johnson C, Mayer M et al (2005) A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a hoosier oncology group study. Support Care Cancer 13:529–534PubMedCrossRefGoogle Scholar
  8. 8.
    Navari R, Einhorn L, Loehrer P, Passik S, Vinson J, McClean J et al (2007) A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a hoosier oncology group study. Support Care Cancer 15:1285–1291PubMedCrossRefGoogle Scholar
  9. 9.
    Passik S, Kirsh K, Theobald D, Dickerson P, Trowbridge R, Gray D et al (2003) A retrospective chart review of the use of olanzapine for the prevention of delayed emesis in cancer patients. J Pain Symptom Manage 25(5):485–489PubMedCrossRefGoogle Scholar
  10. 10.
    Passik S, Navari R, Jong S, Nagy C, Vinson J, Kirsh K et al (2004) A phase I trial of olanzapine (zyprexa) for the prevention of delayed emesis in cancer patients: a hoosier oncology group study. Cancer Invest 22(3):383–388PubMedCrossRefGoogle Scholar
  11. 11.
    Passik S, Lundberg J, Kirsh K, Theobald D, Donaghy K, Holtsclaw E et al (2002) A pilot exploration of the antiemetic activity of olanzapine for the relief of nausea in patients with advanced cancer and pain. J Pain Symptom Manage 23(6):526–532PubMedCrossRefGoogle Scholar
  12. 12.
    Wang X, Feng Y, Chen Y, Gao B, Han B (2014) A meta-analysis of olanzapine for the prevention of chemotherapy-induced nausea and vomiting. Sci Rep 4:4813PubMedGoogle Scholar
  13. 13.
    Mayberg H, Silva J, Brannan S, Tekell J, Mahurin R, McGinnis S et al (2002) The functional neuroanatomy of the placebo effect. Am J Psychiatr 159(5):728–737PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ronald Chow
    • 1
  • Leonard Chiu
    • 1
  • Rudolph Navari
    • 2
  • Steven Passik
    • 3
  • Nicholas Chiu
    • 1
  • Marko Popovic
    • 1
  • Henry Lam
    • 1
  • Mark Pasetka
    • 1
  • Edward Chow
    • 1
    • 4
    Email author
  • Carlo DeAngelis
    • 1
  1. 1.Sunnybrook Odette Cancer CentreUniversity of TorontoTorontoCanada
  2. 2.Indiana University School of MedicineSouth BendUSA
  3. 3.Millenium HealthSan DiegoUSA
  4. 4.Department of Radiation Oncology, Odette Cancer CentreSunnybrook Health Sciences CentreTorontoCanada

Personalised recommendations