The Efficacy and Safety of Adding Olanzapine to Triple Drugs Regimen to Prevent Chemotherapy-induced Nausea and Vomiting: A systematic Review and Meta-analysis of RCTs

Chemotherapy-induced nausea and vomiting (CINV) is a complication of highly emetogenic chemotherapy (HEC) agents. The present meta-analysis was conducted to quantify analyze the efficacy safety adding olanzapine Neurokinin Receptor Antagonist (NKRA) based triple-drug regimen in preventing HEC-induced CINV. Electronic database searches PUBMED Cochrane library using MeSH search terms “olanzapine” “chemotherapy-induced vomiting.” Randomized or cross-over trials comparing “olanzapine + NKRA regimen” vs. “placebo patients age > 18 years with any malignancy receiving HEC were considered under inclusion criteria. Complete Response (CR) for delayed (25–120 h) phase CINV agents primary outcome measure analyzed. Outcome measures estimated by calculating Risk Difference (RD) values their 95% Confidence Intervals (CI). Mantel-Haenszel method both fixed random effect models used analysis Revman 5.4.1 soft- ware. An additional 14% (RD: 0.14, CI: 0.09 0.19) treated had statistically significant higher CR when compared placebo NKRA-based regimen. Adding at 10mg significantly improves rates 16% ‘no nausea’ 30%. Results need be interpreted cautiously background response variations limited included our