Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2017 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Efficacy of olanzapine for prevention of chemotherapy-induced nausea and vomiting: A systematic review and meta-analysis.
Symptom Management/Supportive Care/Palliative Care
Patient and Survivor Care
2017 ASCO Annual Meeting
J Clin Oncol 35, 2017 (suppl; abstr e21692)
Author(s): Rohit Kumar, Naina Singh, Romy Jose Thekkekara, Sunny R K Singh, Sarah Elizabeth Harrington, Mousami Shah; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Subharti Dental College, Meerut, India; The John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; University of Arkansas for Medical Sciences, Little Rock, AR; John H. Stroger, Jr. Hospital of Cook County, Oak Brook, IL
Background: Olanzapine is an atypical antipsychotic medication which has shown efficacy in prevention of chemotherapy-induced nausea and vomiting (CINV) in multiple trials. This study aims to investigate the efficacy of Olanzapine to prevent CINV with an up-to-date systematic review and meta-analysis. Methods: A literature search of Ovid MEDLINE, Embase and Cochrane library was performed to identify randomized controlled trials of olanzapine compared to other antiemetic therapy (5HT3 and/or NK1 antagonist with or without steroids) for prevention of CINV in patients age >=18 years up until December 2016. The primary endpoint was no emesis or nausea episodes in acute (0-24hrs), delayed (24-120hrs) and overall (0-120hrs) period in patients receiving highly or moderately emetogenic chemotherapy (HEC or MEC). Statistical analysis was performed using Review Manager (RevMan 5.3). The Mantel–Haenszel method was applied and random effect analysis model was used to calculate risk ratios. Results: From the literature, 12 RCTs met the inclusion criteria. The age range of patients was 18-89 years. Seven trials included only patients who received HEC while 5 trials included patients receiving either HEC or MEC in various proportions. Olanzapine was statistically superior for 5 primary endpoints except for no nausea in acute period (Table 1). In the non-steroids cohort, olanzapine was superior for no emesis in all 3 periods but statistically significant only for delayed period. Conclusions: Olanzapine is superior to other antiemetic therapy for prevention of CINV. It is less expensive and can improve patient’s quality of life and chemotherapy adherence.
|Outcome||No. of studies||No. of Participants||Risk Ratio (95% CI)|
|1. No emesis||• Acute period||11||1490||1.12 (1.04, 1.21)|
|• Delayed period||11||1458||1.27 (1.12, 1.43)|
|• Overall period||12||1519||1.37 (1.17, 1.61)|
|2. No nausea||• Acute period||8||1272||1.11 (0.99, 1.24)|
|• Delayed period||8||1261||1.49 (1.18, 1.87)|
|• Overall period||8||1262||1.49 (1.17, 1.91)|
Meeting: 2017 ASCO Annual Meeting Abstract No: LBA10001 First Author: Gary Rodin
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Meeting: 2017 ASCO Annual Meeting Abstract No: 10005 First Author: Areej El-Jawahri