Multicenter randomized phase 3 trial of olanzapine as antiemetic prophylaxis in moderately emetogenic chemotherapy

The value of olanzapine as antiemetic prophylaxis in moderately emetogenic chemotherapy (MEC) has not been adequately evaluated. A phase 3 trial at three centers in India randomized patients receiving oxaliplatin-, carboplatin-, or irinotecan-based chemotherapy 1:1 to dexamethasone, aprepitant, palonosetron plus olanzapine (n=274) or dexamethasone, aprepitant, and palonosetron without olanzapine (n=270). In this trial, addition of olanzapine improved complete response rates from 82% to 91%. The authors conclude that olanzapine should be considered as one as the standards of care to reduce chemotherapy-induced nausea and vomiting among patients receiving MEC (visual abstract).