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

Legese Chelkeba, Kidu Gidey, Ayele Mamo, Berhane Yohannes, Tsehay Matso, Tsegaye Melaku

Abstract


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.


Keywords


Antineoplastic Agents; Drug-Related Side Effects and Adverse Reactions; Nausea; Vomiting; Primary Prevention; Meta-Analysis as Topic

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References


Rao KV, Faso A. Chemotherapy-induced nausea and vomiting: optimizing prevention and management. Am Health Drug Benefits. 2012;5(4):232-240.

Bloechl-Daum B, Deuson RR, Mavros P, Hansen M, Herrstedt J. Delayed nausea and vomiting continue to reduce patients' quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol. 2006;24(27):4472-4478.

Hesketh PJ, Bohlke K, Lyman GH, Basch E, Chesney M, Clark-Snow RA, Danso MA, Jordan K, Somerfield MR, Kris MG; American Society of Clinical Oncology. Antiemetics: American Society of Clinical Oncology focused guideline update. J Clin Oncol. 2016;34(4):381-386. doi: 10.1200/JCO.2015.64.3635

Schwartzberg LS. Highlights in CINV From the 2016 MASCC/ISOO Annual Meeting. Clin Adv Hematol Oncol. 2016;14 (Suppl 10(8)):20-23.

Takahashi T, Hoshi E, Takagi M, Katsumata N, Kawahara M, Eguchi K. Multicenter, phase II, placebo‐controlled, double‐blind, randomized study of aprepitant in Japanese patients receiving high‐dose cisplatin. Cancer Sci. 2010;101(11):2455-2461. doi: 10.1111/j.1349-7006.2010.01689.x

Pirl WF, Roth AJ. Remission of chemotherapy‐induced emesis with concurrent olanzapine treatment: a case report. Psychooncology. 2000 Jan-Feb;9(1):84-87.

Jordan K, Jahn F, Aapro M. Recent developments in the prevention of chemotherapy-induced nausea and vomiting (CINV): a comprehensive review. Ann Oncol. 2015;26(6):1081-1090. doi: 10.1093/annonc/mdv138

Bymaster FP, Calligaro DO, Falcone JF, Marsh RD, Moore NA, Tye NC, Seeman P, Wong DT. Radioreceptor binding profile of the atypical antipsychotic olanzapine. Neuropsychopharmacology. 1996;14(2):87-96. doi: 10.1016/0893-133X(94)00129-N

Hesketh PJ. Chemotherapy-induced nausea and vomiting. N Engl J Med. 2008;358(23):2482-2494. doi: 10.1056/NEJMra0706547

Park S, Choi C, Kwon M, Tae J, Kim H. A phase II trial of palonosetron and olanzapine without dexamethasone for the prevention of chemotherapy-induced nausea and vomiting. Supp Care Canc. 2015;23(Suppl 1):S147.

Navari RM, Einhorn LH, Passik SD, Loehrer PJ Sr, Johnson C, Mayer ML, McClean J, Vinson J, Pletcher W. A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier Oncology Group study. Support Care Cancer. 2005 Jul;13(7):529-34. doi: 10.1007/s00520-004-0755-6

Passik SD, Navari RM, Jung SH, Nagy C, Vinson J, Kirsh KL, Loehrer P. A phase I trial of olanzapine (Zyprexa) for the prevention of delayed emesis in cancer patients: a Hoosier Oncology Group study. Cancer Invest. 2004;22(3):383-388.

Passik SD, Lundberg J, Kirsh KL, Theobald D, Donaghy K, Holtsclaw E, Cooper M, Dugan W. 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. 2002;23(6):526-532.

Chow R, Chiu L, Navari R, Passik S, Chiu N, Popovic M, Lam H, Pasetka M, Chow E, DeAngelis C. 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. Support Care Cancer. 2016;24(2):1001-1008. doi: 10.1007/s00520-015-3000-6

Passik SD, Kirsh KL, Theobald DE, Dickerson P, Trowbridge R, Gray D, Beaver M, Comparet J, Brown J. A retrospective chart review of the use of olanzapine for the prevention of delayed emesis in cancer patients. J Pain Symptom Manage. 2003;25(5):485-488.

Vig S, Seibert L, Green MR. Olanzapine is effective for refractory chemotherapy-induced nausea and vomiting irrespective of chemotherapy emetogenicity. J Cancer Res Clin Oncol. 2014;140(1):77-82. doi: 10.1007/s00432-013-1540-z

Flank J, Thackray J, Nielson D, August A, Schechter T, Alexander S, Sung L, Dupuis LL. Olanzapine for treatment and prevention of acute chemotherapy-induced vomiting in children: a retrospective, multi-center review. Pediatr Blood Cancer. 2015;62(3):496-501. doi: 10.1002/pbc.25286

Chiu L, Chiu N, Chow R, Zhang L, Pasetka M, Stinson J, Lechner B, Pulenzas N, Verma S, Chow E, DeAngelis C. Olanzapine for the prophylaxis and rescue of chemotherapyinduced nausea and vomiting (CINV): a retrospective study. Ann Palliat Med. 2016;5(3):172-178. doi: 10.21037/apm.2016.04.05

Abe M, Hirashima Y, Kasamatsu Y, Kado N, Komeda S, Kuji S, Tanaka A, Takahashi N, Takekuma M, Hihara H, Ichikawa Y, Itonaga Y, Hirakawa T, Nasu K, Miyagi K, Murakami J, Ito K. Efficacy and safety of olanzapine combined with aprepitant, palonosetron, and dexamethasone for preventing nausea and vomiting induced by cisplatin-based chemotherapy in gynecological cancer: KCOG-G1301 phase II trial. Support Care Cancer. 2016;24(2):675-682. doi: 10.1007/s00520-015-2829-z

Navari R, Nagy C, Le-Rademacher J, Loprinzi C. Olanzapine versus fosaprepitant for the prevention of concurrent chemotherapy radiotherapy-induced nausea and vomiting. J Community Support Oncol. 2016;14(4):141-147. doi: 10.12788/jcso.0245

Navari RM, Gray SE, Kerr AC. Olanzapine versus aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a randomized phase III trial. J Support Oncol. 2011;9(5):188-195. doi: 10.1016/j.suponc.2011.05.002

Navari RM, Nagy CK, editors. Olanzapine versus fosaprepitant for the prevention of nausea and vomiting in patients receiving concurrent chemoradiation treatment. ASCO Annual Meeting Proceedings; 2015. http://meetinglibrary.asco.org/content/143945-156 (accessed on 27 Fbruary 2017).

Shumway N, Terrazzino S, Jones C, editors. A randomized pilot study comparing aprepitant to olanzapine for treatment of chemotherapy-induced nausea and vomiting. ASCO Annual Meeting Proceedings; 2009. http://meetinglibrary.asco.org/content/30941-65 (accessed on 26 February 2017).

Tan L, Liu J, Liu X, Chen J, Yan Z, Yang H, Zhang D. Clinical research of Olanzapine for prevention of chemotherapy-induced nausea and vomiting. J Exp Clin Cancer Res. 2009;28:131. doi: 10.1186/1756-9966-28-131

Wang X. Wang L. Effectiveness of olanzapine in prevention of chemotherapy-induced nausea and vomiting. Clin J Clinicians (Electronic Edition). 2012;6:7406–7407.

Wang X, Wang L, Wang H, Zhang H. Effectiveness of olanzapine combined with ondansetron in prevention of chemotherapy-induced nausea and vomiting of non-small cell lung cancer. Cell Biochem Biophys. 2015;72(2):471-473. doi: 10.1007/s12013-014-0489-0

Lu Y, Liu W, Du Y, Wang L. [Antiemetic effect of low dose olanzapine in solid tumor chemotherapy]. Chin J Cancer Prev Treat. 2013;20(7):544-554.

Mao W, Peng L. Clinical observation of Olanzapine combined with Granisetrom and Hexadecadrol prevent nausea vomit induced by chemoradiotherapy. Chin J Med Guid. 2011;13:452-454.

Mizukami N, Yamauchi M, Koike K, Watanabe A, Ichihara K, Masumori N, Yamakage M. Olanzapine for the prevention of chemotherapy-induced nausea and vomiting in patients receiving highly or moderately emetogenic chemotherapy: a randomized, double-blind, placebo-controlled study. J Pain Symptom Manage. 2014;47(3):542-550. doi: 10.1016/j.jpainsymman.2013.05.003

Mukhopadhyay S, Kwatra G, Alice KP, Badyal D. Role of olanzapine in chemotherapy-induced nausea and vomiting on platinum-based chemotherapy patients: a randomized controlled study. Support Care Cancer. 2017;25(1):145-154

Babu G, Saldanha SC, Kuntegowdanahalli Chinnagiriyappa L, Jacob LA, Mallekavu SB, Dasappa L, Kiran PR, Sreevatsa A, Appachu S, Unnikrishnan V, Arroju V. The efficacy, safety, and cost benefit of olanzapine versus aprepitant in highly emetogenic chemotherapy: a pilot study from South India. Chemother Res Pract. 2016;2016:3439707. doi: 10.1155/2016/3439707

Navari RM, Aapro M. Antiemetic Prophylaxis for Chemotherapy-Induced Nausea and Vomiting. N Engl J Med. 2016;374(14):1356-1367. doi: 10.1056/NEJMra1515442

Wang XF, Feng Y, Chen Y, Gao BL, Han BH. A meta-analysis of olanzapine for the prevention of chemotherapy-induced nausea and vomiting. Sci Rep. 2014;4:4813. doi: 10.1038/srep04813

Chiu L, Chow R, Popovic M, Navari RM, Shumway NM, Chiu N, Lam H, Milakovic M, Pasetka M, Vuong S, Chow E, DeAngelis C. Efficacy of olanzapine for the prophylaxis and rescue of chemotherapy-induced nausea and vomiting (CINV): a systematic review and meta-analysis. Support Care Cancer. 2016;24(5):2381-2392. doi: 10.1007/s00520-016-3075-8

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100. doi: 10.1371/journal.pmed.1000100

Roila F, Herrstedt J, Aapro M, Gralla RJ, Einhorn LH, Ballatori E, Bria E, Clark-Snow RA, Espersen BT, Feyer P, Grunberg SM, Hesketh PJ, Jordan K, Kris MG, Maranzano E, Molassiotis A, Morrow G, Olver I, Rapoport BL, Rittenberg C, Saito M, Tonato M, Warr D; ESMO/MASCC Guidelines Working Group. Guideline update for MASCC and ESMO in the prevention of chemotherapy-and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol. 2010;21(Suppl 5):v232-v243. doi: 10.1093/annonc/mdq194

Goodin S, Cunningham R. 5-HT3-receptor antagonists for the treatment of nausea and vomiting: a reappraisal of their side-effect profile. Oncologist. 2002;7(5):424-436.

Hesketh PJ, Grunberg SM, Gralla RJ, Warr DG, Roila F, de Wit R, Chawla SP, Carides AD, Ianus J, Elmer ME, Evans JK, Beck K, Reines S, Horgan KJ; Aprepitant Protocol 052 Study Group. The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin—the Aprepitant Protocol 052 Study Group. J Clin Oncol. 2003;21(22):4112-4119.

Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, Julie Ma G, Eldridge K, Hipple A, Evans JK, Horgan KJ, Lawson F; Aprepitant Protocol 054 Study Group. Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy‐induced nausea and vomiting. Cancer. 2003;97(12):3090-3098.

Schmoll HJ, Aapro MS, Poli-Bigelli S, Kim HK, Park K, Jordan K, von Pawel J, Giezek H, Ahmed T, Chan CY. Comparison of an aprepitant regimen with a multiple-day ondansetron regimen, both with dexamethasone, for antiemetic efficacy in high-dose cisplatin treatment. Ann Oncol. 2006;17(6):1000-1006.

Saito M, Aogi K, Sekine I, Yoshizawa H, Yanagita Y, Sakai H, Inoue K, Kitagawa C, Ogura T, Mitsuhashi S. Palonosetron plus dexamethasone versus granisetron plus dexamethasone for prevention of nausea and vomiting during chemotherapy: a double-blind, double-dummy, randomised, comparative phase III trial. Lancet Oncol. 2009;10(2):115-124. doi: 10.1016/S1470-2045(08)70313-9

Aapro M, Rugo H, Rossi G, Rizzi G, Borroni ME, Bondarenko I, Sarosiek T, Oprean C, Cardona-Huerta S, Lorusso V, Karthaus M, Schwartzberg L, Grunberg S. A randomized phase III study evaluating the efficacy and safety of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy. Ann Oncol. 2014;25(7):1328-1333. doi: 10.1093/annonc/mdu101

Maeda A, Ura T, Asano C, Haegawa I, Nomura M, Komori A, Narita Y, Taniguchi H, Kadowaki S, Muro K, Horio Y, Yoshida T, Oze I, Kajita M, Mizutani A. A phase II trial of prophylactic olanzapine combined with palonosetron and dexamethasone for preventing nausea and vomiting induced by cisplatin. Asia Pac J Clin Oncol. 2016;12(3):254-258. doi: 10.1111/ajco.12489

Nagashima K, Iwasa S, Yanai T, Hashimoto H, Suzuki K, Ohyanagi F, Shimada Y, Yamamoto N. A double-blind randomized Phase II study of olanzapine 10 mg versus 5 mg for emesis induced by highly emetogenic chemotherapy. Jpn J Clin Oncol. 2015;45(2):229-231. doi: 10.1093/jjco/hyu191


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