TY - JOUR
T1 - Effects of adding a neurokinin-1 receptor antagonist to 5 mg olanzapine, a 5-hydroxytryptamine-3 receptor antagonist, and dexamethasone for preventing carboplatin-induced nausea and vomiting
T2 - a propensity score-matched analysis
AU - Yamamoto, Senri
AU - Iihara, Hirotoshi
AU - Uozumi, Ryuji
AU - Kawazoe, Hitoshi
AU - Tanaka, Kazuki
AU - Fujita, Yukiyoshi
AU - Abe, Masakazu
AU - Imai, Hisao
AU - Karayama, Masato
AU - Hayasaki, Yoh
AU - Hirose, Chiemi
AU - Suda, Takafumi
AU - Nakamura, Kazuto
AU - Suzuki, Akio
AU - Ohno, Yasushi
AU - Morishige, Ken ichirou
AU - Inui, Naoki
N1 - Funding Information:
We are grateful to all the patients and their families for participating in this study. We would like to thank Editage (www.editage.com) for English language editing.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: Olanzapine has been reported to be an effective antiemetic in patients receiving carboplatin-based chemotherapy. However, the efficacy of a neurokinin-1 receptor antagonist (NK1RA) added to olanzapine, a 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA), and dexamethasone (DEX) has not been proven. This study aimed to assess the efficacy and safety of NK1RA, in combination with three-drug antiemetic regimens containing olanzapine, in preventing nausea and vomiting induced by carboplatin-based chemotherapy. Methods: Data were pooled for 140 patients receiving carboplatin-based chemotherapy from three multicenter, prospective, single-arm, open-label phase II studies that evaluated the efficacy and safety of olanzapine for chemotherapy-induced nausea and vomiting. The propensity score of the co-administration of NK1RA was estimated for each patient using a logistic regression model that included age, sex, and carboplatin dose. We analyzed a total of 62 patients, who were treated without NK1RA (non-NK1RA group: 31 patients) and with NK1RA (NK1RA group: 31 patients). The patients were selected using propensity score matching. Results: The complete response rate (without emetic episodes or with no administration of rescue medication) in the overall period (0–120 h post carboplatin administration) was 93.5% in the non-NK1RA group and 96.8% in the NK1RA group, with a difference of -3.2% (95% confidence interval, -18.7% to 10.9%; P = 1.000). In terms of safety, there was no significant difference between the groups in daytime sleepiness and concentration impairment, which are the most worrisome adverse events induced by olanzapine. Conclusions: The findings suggest that antiemetic regimens consisting of olanzapine, 5HT3RA, and DEX without NK1RA may be a treatment option for patients receiving carboplatin-based chemotherapy.
AB - Background: Olanzapine has been reported to be an effective antiemetic in patients receiving carboplatin-based chemotherapy. However, the efficacy of a neurokinin-1 receptor antagonist (NK1RA) added to olanzapine, a 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA), and dexamethasone (DEX) has not been proven. This study aimed to assess the efficacy and safety of NK1RA, in combination with three-drug antiemetic regimens containing olanzapine, in preventing nausea and vomiting induced by carboplatin-based chemotherapy. Methods: Data were pooled for 140 patients receiving carboplatin-based chemotherapy from three multicenter, prospective, single-arm, open-label phase II studies that evaluated the efficacy and safety of olanzapine for chemotherapy-induced nausea and vomiting. The propensity score of the co-administration of NK1RA was estimated for each patient using a logistic regression model that included age, sex, and carboplatin dose. We analyzed a total of 62 patients, who were treated without NK1RA (non-NK1RA group: 31 patients) and with NK1RA (NK1RA group: 31 patients). The patients were selected using propensity score matching. Results: The complete response rate (without emetic episodes or with no administration of rescue medication) in the overall period (0–120 h post carboplatin administration) was 93.5% in the non-NK1RA group and 96.8% in the NK1RA group, with a difference of -3.2% (95% confidence interval, -18.7% to 10.9%; P = 1.000). In terms of safety, there was no significant difference between the groups in daytime sleepiness and concentration impairment, which are the most worrisome adverse events induced by olanzapine. Conclusions: The findings suggest that antiemetic regimens consisting of olanzapine, 5HT3RA, and DEX without NK1RA may be a treatment option for patients receiving carboplatin-based chemotherapy.
KW - 5-hydroxytryptamine-3 receptor antagonists
KW - Antiemetics
KW - Carboplatin
KW - Dexamethasone
KW - Nausea
KW - Neurokinin-1 receptor antagonist
KW - Olanzapine
KW - Vomiting
UR - http://www.scopus.com/inward/record.url?scp=85126901196&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85126901196&partnerID=8YFLogxK
U2 - 10.1186/s12885-022-09392-9
DO - 10.1186/s12885-022-09392-9
M3 - Article
C2 - 35321690
AN - SCOPUS:85126901196
SN - 1471-2407
VL - 22
JO - BMC cancer
JF - BMC cancer
IS - 1
M1 - 310
ER -
