Evidence map›Paper›PMID 41731226›Full record

Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026

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.

Warangkana Harikul, Akarin Nimmannit, Apirom Laocharoenkeat, Pochamana Phisalprapa, Chayanis Kositamongkol, Phurita Thongkijpreecha, Suthinee Ithimakin

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Olanzapine (10 mg vs 5 mg vs 2.5 mg) for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV) - a systematic review and network meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Warangkana HarikulDivision of Medical Oncology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Akarin NimmannitDepartment of Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Apirom LaocharoenkeatPharmacy Department, Siriraj Hospital, Bangkok, Thailand.
Pochamana PhisalprapaDivision of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Chayanis KositamongkolDivision of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Phurita ThongkijpreechaPharmacy Department, Siriraj Hospital, Bangkok, Thailand.
Suthinee IthimakinDivision of Medical Oncology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. aesi105@yahoo.co.th.

Funding

Siriraj Research Development Fund (Managed by Routine to Research: R2R), Mahidol University (IO) R016835007
6 · The paper itself

Abstract

purposeA 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 mg) combined with ondansetron and dexamethasone in preventing chemotherapy-induced nausea and vomiting (CINV).

methodsIn 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 1-4, with ondansetron and dexamethasone. Randomization was stratified by chemotherapy type and high-risk factors (female aged < 50 years). The primary endpoint was total protection (mild/no nausea, no vomiting, and no rescue therapy) within 120 h post-chemotherapy. Secondary endpoints included total control, complete response, nausea/vomiting severity, rescue use, adverse events, and patient satisfaction.

resultsAmong 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 (p = 0.06). Total control was significantly higher with OLN (62.3% vs. 38.6%, p = 0.005). Delayed nausea (grade ≥ 2) occurred less frequently with OLN (13.0% vs. 30.0%, p = 0.015). 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 (p = 0.001).

conclusionOlanzapine (5 mg) combined with ondansetron and dexamethasone was associated with a moderate improvement in total protection and significant improvements in no-nausea and total control rates.

Indexed as

AntiemeticsAntineoplastic Combined Chemotherapy ProtocolsBenzodiazepinesNauseaVomitingAdultAgedCarboplatinDexamethasoneDouble-Blind MethodDrug Therapy, CombinationFemaleHumansIrinotecanMaleMiddle AgedAntiemeticsBenzodiazepinesCarboplatinDexamethasoneIrinotecanOlanzapineOndansetronOrganoplatinum CompoundsOxaliplatinCarboplatinIrinotecanModerately emetogenic chemotherapyOlanzapineOxaliplatin

Identifiers

PMID41731226
PMCPMC12929264

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.