Evaluation of the Efficacy and Safety of Palonosetron + Dexamethasone (1-day) + Fosaprepitant + Olanzapine (2.5 mg) in Patients with Lung Cancer Undergoing Carboplatin-based Chemotherapy

Abstract

Chemotherapy-induced nausea and vomiting (CINV) remains an unresolved medical condition, and suitable combinations for a 1-day dexamethasone antiemetic regimen have not been adequately investigated for carboplatin-based chemotherapy. Herein, we evaluated the efficacy of olanzapine (2.5 mg) combined with an NK1 receptor antagonist, a 5-HT₃ receptor antagonist, and a 1-day dexamethasone antiemetic regimen in patients with lung cancer who received carboplatin-based chemotherapy. The efficacy and safety of olanzapine against CINV were compared between two propensity score–matched groups of 22 patients each. The primary endpoint, complete response rate in the delayed phase, and secondary endpoints, including the overall incidence of nausea, incidence of grade ≥2 nausea, and time to treatment failure, were considerably improved in the olanzapine group. The results indicate that the addition of olanzapine (2.5 mg) to a triple antiemetic regimen of an NK1 receptor antagonist, a 5-HT₃ receptor antagonist, and 1-day dexamethasone may be a useful option for patients undergoing carboplatin-based chemotherapy.