Olanzapine Dose Comparison for the Prevention of HER-INV: A Network Meta-Analysis
Olanzapine 2.5 mg Versus 5 mg Versus 10 mg in Highly Emetogenic Regimens: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.
Shandong Cancer Hospital and Institute
2,000 participants
Jan 18, 2026
OBSERVATIONAL
Conditions
Summary
Olanzapine is an effective antiemetic agent for preventing highly emetogenic regimens-induced nausea and vomiting (HER-INV) in patients receiving highly emetogenic regimens (HER). The optimal dose remains debated, with the standard 10 mg dose often causing significant daytime sedation. Recent evidence suggests that lower doses (2.5 mg and 5 mg) may offer comparable efficacy with improved tolerability. However, no head-to-head randomized controlled trials (RCTs) directly compare all three doses.
Eligibility
Inclusion Criteria6
- Olanzapine was used to prevent nausea and vomiting (HER-INV) in solid tumors patients receiving highly emetogenic regimens.
- Randomized controlled trials (RCTs), including conference abstracts if sufficient data are provided.
- Adult patients (≥18 years) with solid tumors receiving highly emetogenic chemotherapy (HEC).
- \. Olanzapine at 2.5 mg, 5 mg, or 10 mg, added to a standard triple antiemetic regimen (NK1 receptor antagonist + 5-HT3 receptor antagonist + dexamethasone).
- \. Any of the other three olanzapine doses or placebo (2.5 mg vs. 5 mg vs. 10 mg, or vs. placebo).
- \. At least one of the pre-specified efficacy or safety outcomes must be reported.
Exclusion Criteria3
- Non-solid tumors patients, non-randomized studies, observational studies, case reports, reviews.
- Studies involving pediatric populations, non-HEC regimens.
- Studies where olanzapine is used as rescue medication only. Studies with overlapping patient populations (the most recent or complete publication will be selected).
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Interventions
Olanzapine (dose: 2.5 mg) vs. olanzapine (dose: 5 mg) vs. olanzapine (dose: 10 mg)
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07403370