title: Olanzapine for preventing nausea and vomiting induced by moderately and highly emetogenic chemotherapy.
abstract: Nausea and vomiting are common adverse events in chemotherapy. In spite of the serious effects on the quality of life and further treatment, they remain overlooked by physicians, and no standard treatment has been developed. Neurokinin-1 (NK-1) receptor antagonists and palonosetron are the major agents in the standard regimen for treating moderately and highly emetogenic chemotherapy-induced nausea and vomiting (CINV). However, NK-1 receptor antagonists first became commercially available at the end of 2013 and palonosetron has not been extensively applied in China. Olanzapine was recommended as a therapy for moderate and severe CINV in antiemesis-clinical practice guidelines in oncology in 2014 for the first time. It is an atypical antipsychotic agent, which can block multiple receptors on neurotransmitters. During more than 10 years, olanzapine has demonstrated significant effects in preventing CINV and treating breakthrough and refractor CINV, which was observed in case reports, precise retrospective studies, and phase I, II and III clinical trials, with no grade 3 to 4 adverse events. In particular, it is superior to aprepitant and dexamethasone in delayed nausea and vomiting. Therefore, this compound is worthy of further investigation.
authors.affiliation: Department of Biotherapy and Laboratory of Biotherapy, the Fourth Affiliated Hospital of China Medical University, Shenyang, China E-mail : cmu4h_swzlk@126.com, sywang66@yahoo.com.
authors.forename: Shi-Yong
authors.initials: SY
authors.lastname: Wang
authors.forename: Zhen-Jun
authors.initials: ZJ
authors.lastname: Yang
authors.forename: Lu
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000077608:Aprepitant; D001569:Benzodiazepines / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use; D004639:Emetics / Q000009:adverse effects; D006801:Humans; D007546:Isoquinolines / Q000627:therapeutic use; D009025:Morpholines / Q000627:therapeutic use; D009325:Nausea / Q000188:drug therapy* / Q000517:prevention & control; D009369:Neoplasms / Q000188:drug therapy; D064729:Neurokinin-1 Receptor Antagonists / Q000627:therapeutic use; D000077152:Olanzapine; D000077924:Palonosetron; D011812:Quinuclidines / Q000627:therapeutic use; D014839:Vomiting / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D004639:Emetics; D007546:Isoquinolines; D009025:Morpholines; D064729:Neurokinin-1 Receptor Antagonists; D011812:Quinuclidines; D001569:Benzodiazepines; D000077608:Aprepitant; D000077924:Palonosetron; D003907:Dexamethasone; D000077152:Olanzapine