{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T21:53:51Z","timestamp":1784238831310,"version":"3.55.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Siriraj Research Development Fund (Managed by Routine to Research: R2R), Mahidol University","award":["(IO) R016835007"],"award-info":[{"award-number":["(IO) R016835007"]}]},{"DOI":"10.13039\/501100004156","name":"Mahidol University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004156","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>A two-drug regimen of palonosetron and dexamethasone is standard for moderately emetogenic chemotherapy (MEC), including oxaliplatin and irinotecan. Current guidelines recommend adding an NK1 receptor antagonist for carboplatin-based or MEC in patients with high-risk features. Given the comparable efficacy of olanzapine, this study evaluated the effectiveness of low-dose olanzapine (OLN, 5\u00a0mg) combined with ondansetron and dexamethasone in preventing chemotherapy-induced nausea and vomiting (CINV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this double-blind, randomized controlled trial, patients initiating oxaliplatin-, carboplatin-, or irinotecan-based chemotherapy were randomized 1:1 to receive OLN or placebo on Days 1\u20134, with ondansetron and dexamethasone. Randomization was stratified by chemotherapy type and high-risk factors (female aged\u2009&lt;\u200950\u00a0years). The primary endpoint was total protection (mild\/no nausea, no vomiting, and no rescue therapy) within 120\u00a0h post-chemotherapy. Secondary endpoints included total control, complete response, nausea\/vomiting severity, rescue use, adverse events, and patient satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 139 evaluable patients, 69 received OLN and 70 received a placebo. Total protection was achieved in 71.0% of OLN patients versus 55.7% with placebo (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06). Total control was significantly higher with OLN (62.3% vs. 38.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Delayed nausea (grade\u2009\u2265\u20092) occurred less frequently with OLN (13.0% vs. 30.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). Complete response and rescue use did not differ between groups. Somnolence rates were similar, but anorexia was less familiar with OLN. Notably, 95.6% of OLN patients preferred to continue the same regimen, compared with 72.9% of placebo recipients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Olanzapine (5\u00a0mg) combined with ondansetron and dexamethasone was associated with a moderate improvement in total protection and significant improvements in no-nausea and total control rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-10490-8","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T01:20:05Z","timestamp":1771896005000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A randomized, double-blind, placebo-controlled trial of olanzapine versus placebo plus ondansetron and dexamethasone for antiemetic prophylaxis in patients receiving oxaliplatin-, irinotecan-, or carboplatin-based chemotherapy"],"prefix":"10.1007","volume":"34","author":[{"given":"Warangkana","family":"Harikul","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akarin","family":"Nimmannit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apirom","family":"Laocharoenkeat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pochamana","family":"Phisalprapa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chayanis","family":"Kositamongkol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phurita","family":"Thongkijpreecha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suthinee","family":"Ithimakin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"10490_CR1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-023-08220-5","volume":"32","author":"K Jordan","year":"2023","unstructured":"Jordan K, Chan A, Gralla RJ et al (2023) Emetic risk classification and evaluation of the emetogenicity of antineoplastic agents-updated MASCC\/ESMO consensus recommendation. 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Approval was granted by the Ethics Committee of Siriraj Hospital, Mahidol University (Protocol No. 811\/2567 (IRB3)\/COA No. Si849\/2024).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants provided informed consent to participate in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All participants provided consent for publication of anonymized data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Written informed consent was obtained from all individual participants included in the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"238"}}