Clinical Observation of Gene Polymorphism of Olanzapine or Aprepitant in Prevention of CINV

Jin, Yilan; Jin, Gaowa; Zhao, Jun; Jiang, Caihong; Zhao, Lanzhen; Jiang, Ying; Chen, Feng; Li, Hui; Wang, Wenjuan; Wu, Yungaowa; Liu, Guang; Li, Xiaorong; Gu, Min; Li, Xiaomei; Li, Quanfu

doi:10.2147/pgpm.s317229

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…Decoding the reasons for these variations in efficacy is difficult due to multiple genetic and non-genetic factors. 5 Nonetheless, publication bias and other biases must be ruled out for these variations. In this background, it is difficult to accurately quantify the benefits of Our out-of objective meta-analysis result of three trials comparing olanzapine vs. NKRAbased triple-drug regimen head-to-head, show no significant difference between the comparison groups.This was evident in the outcome measuresof CR and 'no nausea' in all three phases of CINV.…”

Section: Characters Of Included Studiesmentioning

confidence: 99%

“…1-4 However, the above triple-drug regimen's efficacy in preventing nausea, especially delayed phase nausea, is incomplete and subjected to individual variations. 4,5 NKRA-based regimens were found to be most effective in preventing CINV, but their efficacy in preventing delayed nausea is comparatively low. 4 To overcome this disadvantage and as a cheaper alternative to NKRAs, olanzapine was tested and found to be equally efficacious in relieving vomiting and superior in relieving delayed phase nausea.…”

Section: Introductionmentioning

confidence: 99%

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The Efficacy and Safety of Adding Olanzapine to Triple Drugs Regimen to Prevent Chemotherapy-induced Nausea and Vomiting: A systematic Review and Meta-analysis of RCTs

Hiremath¹,

Devendrappa²

2022

Pharmacology and Clinical Pharmacy Research (PCPR) is an intern

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Chemotherapy-induced nausea and vomiting (CINV) is a complication of highly emetogenic chemotherapy (HEC) agents. The present meta-analysis was conducted to quantify and analyze the efficacy and safety of adding olanzapine to a Neurokinin Receptor Antagonist (NKRA) based triple-drug regimen in preventing HEC-induced CINV. Electronic database searches in PUBMED and Cochrane library was conducted using MeSH search terms “olanzapine” and “chemotherapy-induced nausea and vomiting.” Randomized or cross-over trials comparing the efficacy of “olanzapine + NKRA based triple-drug regimen” vs. “placebo + NKRA based triple-drug regimen” in patients of age > 18 years with any malignancy receiving HEC were considered under inclusion criteria. Complete Response (CR) for the delayed (25–120 h) phase of CINV in patients receiving HEC agents was the primary outcome measure analyzed. Outcome measures were estimated by calculating the Risk Difference (RD) values and their 95% Confidence Intervals (CI). The Mantel-Haenszel method and both fixed and random effect models were used in the analysis by Revman 5.4.1 soft- ware. An additional 14% (RD: 0.14, 95% CI: 0.09 to 0.19) of patients treated with olanzapine + triple-drug regimen had a statistically significant higher CR in the delayed phase when compared to placebo + NKRA-based triple-drug regimen. Adding olanzapine at 10mg to the triple-drug regimen significantly improves delayed phase CR rates by 16% and delayed phase ‘no significant nausea’ rates by 30%. Results need to be interpreted cautiously in the background of response variations and limited trials included in our analysis

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Section: Characters Of Included Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Efficacy and Safety of Adding Olanzapine to Triple Drugs Regimen to Prevent Chemotherapy-induced Nausea and Vomiting: A systematic Review and Meta-analysis of RCTs

Hiremath¹,

Devendrappa²

2022

Pharmacology and Clinical Pharmacy Research (PCPR) is an intern

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“…CINV can lead to electrolyte imbalance, dehydration, malnutrition, and esophageal damage, which not only affects the quality of life of patients, but also reduces overall survival and increases treatment costs [ 1 ]. A review of clinical trials identified several clinical risk factors for CINV: female sex, younger age, history of low-dose alcohol consumption and dizziness [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…This study is based on our previous study of ABCB1 rs1045642, female is an independent risk factor for CINV [ 1 ]. We combined the 42 SNPs of metabolic enzymes, transporters and targeting receptors reported in domestic and foreign literatures that may be related to CINV to explore the relationship between related SNPs and CINV susceptibility.…”

Section: Introductionmentioning

confidence: 99%

A randomized trial evaluating the association between related gene polymorphism and nausea and vomiting induced by cisplatin multi-day chemotherapy

Jin,

Chen,

Zhao

et al. 2023

BMC Med Genomics

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Purpose We aim to investigate the correlation between gene polymorphisms and cisplatin chemotherapy-induced nausea and vomiting (CINV), which was prevented by olanzapine or aprepitant triple antiemetic regimen. Methods Before chemotherapy, the blood samples of 89 malignant tumor patients who received multi-day chemotherapy with cisplatin were collected for sequencing and typing. As there were duplicate patients enrolled in different chemotherapy cycles, there were a total of 190 cases. The patients were divided into two groups randomly, who received the triple antiemetic regimen of olanzapine or aprepitant combined with 5-HT3RA and dexamethasone. The main evaluation indicators were the total protection (TP) rate in the acute phase (0–24 h), the delayed phase (25–120 h) and the overall phase (0-120 h). Results Univariate analysis was performed on genetic loci that reached H-W balance with TP. In the olanzapine group, increased TP in the acute phase was associated with HTR3A rs1176719 non-GG (P < 0.05) genotype etc. Increased TP in the delayed phase was associated with HTR3A rs1176719 non-GG (P < 0.05) genotype etc. In the aprepitant group, increased TP in the acute phase was associated with the MTHFR rs1801131 TT (P < 0.05) genotype etc. Increased TP in the delayed phase was associated with HTR3A rs1062613 CC (P < 0.05) genetype ect. Multivariate Logistic regression analysis showed that HTR3B rs7943062GG (P < 0.05) genotype etc. were correlated with increased TP in the delayed phase. MTHFR rs1801131TT genotype was associated with increased TP in the acute phase (P < 0.05) and delayed phase (P < 0.05). Conclusion This study found that gene polymorphisms, including HTR3B (rs1062613, rs1176719, rs2276303), HTR3B (rs45460698, rs7943062), HTR3C (rs6766410), ERCC1 (rs3212986), ERCC4 (rs744154) and MTHFR(rs1801131), may be independent prognostic factors for CINV.

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Low Dose Olanzapine in the Prevention and Treatment of Carboplatin Induced Nausea and Vomiting: A Prospective Clinical Randomized Controlled Trial

Jin¹,

Li²,

An³

et al. 2023

CPD

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Objective: This study aimed to determine the effectiveness and safety of 5 mg olanzapine (OLZ) in preventing vomiting and nausea caused by carboplatin chemotherapy. Methods: All patients with malignant tumors (n = 113) who underwent Carboplatin (AUC ≥5) treatment were randomly categorized into two groups: the standard group (n = 57) and the OLZ regimen (n = 56). The major endpoints of the trial were the TC (total control) between two groups during the OP (Overall phase, 0-120 hours), DP (delayed phase, 25-120 hours), and AP (acute phase, 0-24 hours). The secondary endpoints were the CR (complete response) and TP (total protection) during AP, OP, and DP. The time of first vomiting was compared between the two groups using Kaplan–Meier curves. The impact of CINV on the quality of life was assessed by the Functional Living Index-Emesis (FLIE). OLZ-related side effects were also recorded. Results: (1) The primary endpoint TC rates were more favorable in the OLZ regimen group than in the standard group during the AP 87.50% (49/56) vs. 63.15% (36/57) P = 0.003, OP 62.50% (35/56) vs. 31.57% (18/57) P = 0.001, and DP 64.28% (36/56) vs. 33.33% (19/57) P = 0.001. (2) The secondary endpoints TP were 82.14% (46/56) vs. 63.15% (36/57), P = 0.024, 83.92% (47/56) vs. 63.15% (36/57). P = 0.012 during the DP and OP. There was no statistical significance during AP between the two groups. The CR rates were not statistically different between the two groups during the three periods, P > 0.05; (3) The first vomiting time in the OLZ group was delayed compared with the standard group (P = 0.248). The effect on life quality (score ≥ 108) assessed by FLIE was 62.50% vs. 43.48% between the two groups, P < 0.05. The primary side effects of OLZ are fatigue (85%) and somnolence (75%). The primary side effects of the standard group are fatigue (77%) and loss of appetite (85%). Conclusion: The 5 mg OLZ-based triple antiemetic regimen is effective and safe in preventing vomiting and nausea induced by Carboplatin.

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Clinical Observation of Gene Polymorphism of Olanzapine or Aprepitant in Prevention of CINV

Cited by 3 publications

References 26 publications

The Efficacy and Safety of Adding Olanzapine to Triple Drugs Regimen to Prevent Chemotherapy-induced Nausea and Vomiting: A systematic Review and Meta-analysis of RCTs

The Efficacy and Safety of Adding Olanzapine to Triple Drugs Regimen to Prevent Chemotherapy-induced Nausea and Vomiting: A systematic Review and Meta-analysis of RCTs

A randomized trial evaluating the association between related gene polymorphism and nausea and vomiting induced by cisplatin multi-day chemotherapy

Low Dose Olanzapine in the Prevention and Treatment of Carboplatin Induced Nausea and Vomiting: A Prospective Clinical Randomized Controlled Trial

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