“ The Effectiveness of Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting in Platinum-Based Chemotherapy ( Cisplatin, Carboplatin and Oxaliplatin)”

Chemotherapy-induced nausea and vomiting (CINV) remains a major adverse effect of cancer treatment despite the use of guideline-recommended antiemetic regimens. Olanzapine has demonstrated antiemetic activity through multi-receptor antagonism and has been increasingly studied as part of prophylactic regimens for CINV. However, existing evidence syntheses often pool heterogeneous chemotherapy regimens and do not adequately evaluate differences across specific platinum agents. This systematic review and meta-analysis aims to assess the effectiveness and safety of olanzapine-containing antiemetic prophylaxis compared with non-olanzapine standard-of-care regimens in adult patients receiving platinum-based chemotherapy, including cisplatin, carboplatin, and oxaliplatin. Primary outcomes include complete response during the acute, delayed, and overall phases, as well as no-nausea rates. Secondary outcomes include nausea severity, sedation, insomnia, rescue medication use, and treatment discontinuation due to adverse effects. Subgroup analyses will evaluate whether the effectiveness of olanzapine differs according to the specific platinum agent used and by emetogenic risk category (highly versus moderately emetogenic chemotherapy). The findings are expected to clarify the role of olanzapine across different platinum-based regimens and support evidence-based optimization of antiemetic strategies in clinical practice.