Objective: The aim of this study is to synthesize the evidence about the efficacy of
Olanzapine for the prevention of CINV.
Methods: A computer literature search of PubMed, EBSCO, Ovid, and Cochrane CENTRAL databases
has been conducted. Studies were screened for eligibility and data were extracted. The proportion
of patients with complete response (CR) and those with no nausea were pooled as risk ratio (RR)
in a fixed effect model meta-analysis using Review Manager Version 5.3 for windows.
Results: Nine randomized controlled trials (n=1572) were pooled in the final analysis. In all studies,
olanzapine was given as 10 mg PO. Olanzapine was superior to active control in terms of CR rate in
acute phase (RR 1.12, 95% CI [1.02, 1.22], p=0.01]), delayed phase (RR 1.31, 95% CI [[1.10, 1.56],
p=0.002), and overall phase (RR 1.30, 95% CI [1.09, 1.55], p=0.004). Rates of no nausea were significantly
higher in olanzapine 10 mg group compared to active control group in acute phase (RR
1.20, 95% CI [1.04, 1.38], p=0.01), delayed phase (RR 1.72, 95% CI [1.42, 2.08], p<0.00001), and
overall phase (RR 1.57, 95% CI [1.39, 1.77], p <0.00001). The incidence of adverse events was similar
in olanzapine and control groups, with the most frequently reported treatment-related emergent
adverse events being fatigue, constipation, and headache.
Conclusion: Olanzapine is a well-tolerated drug for cancer patients and has shown superiority
against conventional antiemetics for the prevention of CINV.