Cancer Research and Treatment

Original Articles

Hematologic malignancy

Intensified First Cycle of Rituximab Plus Eight Cycles of Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone with Rituximab Chemotherapy for Advanced-Stage or Bulky Diffuse Large B-Cell Lymphoma: A Multicenter Phase II Consortium for Improving Survival of Lymphoma (CISL) Study: Yu Ri Kim, Jin Seok Kim, Won Seog Kim, Hyeon Seok Eom, Deok-Hwan Yang, Sung Hwa Bae, Hyo Jung Kim, Jae Hoon Lee, Suk-Joong Oh, Sung-Soo Yoon, Jae-Yong Kwak, Chul Won Choi, Min Kyoung Kim, Sung Young Oh, Hye Jin Kang, Seung Hyun Nam, Hyeok Shim, Joon Seong Park, Yeung-Chul Mun, Cheolwon Suh, the Korean Society of Hematology Lymphoma Working Party; Cancer Res Treat. 2023;55(4):1355-1362. Published online March 30, 2023; DOI: https://doi.org/10.4143/crt.2023.271

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Purpose
This phase II, open-label, multicenter study aimed to investigate the efficacy and safety of a rituximab intensification for the 1st cycle with every 21-day of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP-21) among patients with previously untreated advanced-stage or bulky diffuse large B-cell lymphoma (DLBCL).
Materials and Methods
Ninety-two patients with stage III/IV or bulky DLBCL from 21 institutions were administered 8 cycles of R-CHOP-21 with an additional one dose of rituximab intensification on day 0 of the 1st cycle (RR-CHOP). The primary endpoint was a complete response (CR) rate after 3 cycles of chemotherapy.
Results
Among the 92 DLBCL patients assessed herein, the response rate after 3 cycles of chemotherapy was 88.0% (38.0% CR+50.0% partial response [PR]). After the completion of 8 cycles of chemotherapy, the overall response rate was observed for 68.4% (58.7% CR+9.8% PR). The 3-year progression-free survival rate was 64.0%, and the 3-year overall survival rate was 70.4%. Febrile neutropenia was one of the most frequent grade 3 adverse events (40.0%) and 5 treatment-related deaths occurred. Compared with the clinical outcomes of patients who received R-CHOP chemotherapy as a historical control, the interim CR rate was higher in male patients with RR-CHOP (20.5% vs. 48.8%, p=0.016).
Conclusion
Rituximab intensification on days 0 to the 1st cycle of the standard 8 cycles R-CHOP-21 for advanced DLBCL yielded favorable response rates after the 3 cycles of chemotherapy and acceptable toxicities, especially for male patients. ClinicalTrials.gov ID: NCT01054781.

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Design, Conduct, and Analysis of Externally Controlled Trials
Jiali Liu, Minghong Yao, Mingqi Wang, Wan Jie, Yanmei Liu, Xiaochao Luo, Jiayidaer Huan, Kelin Deng, Ke Deng, Kang Zou, Ying Zhang, Ling Li, Xin Sun
JAMA Network Open.2025; 8(9): e2530277. CrossRef

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A Randomized, Double-Blind, Placebo-Controlled Study of the Safety and Efficacy of Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Moderately Emetogenic Chemotherapy: Results of the Korean South West Oncology Group (KSWOG) Study: So-Yeon Jeon, Hye Sook Han, Woo Kyun Bae, Moo-Rim Park, Hyeok Shim, Sang-Cheol Lee, Se-Il Go, Hwan Jung Yun, Yong-Jin Im, Eun-Kee Song; Cancer Res Treat. 2019;51(1):90-97. Published online February 27, 2018; DOI: https://doi.org/10.4143/crt.2017.577

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Purpose
Data on the efficacy of olanzapine in patients receiving moderately emetogenic chemotherapy (MEC) are limited. This study aimed to evaluate and compare the efficacy of olanzapine versus placebo in controlling nausea and vomiting in patients receiving MEC.
Materials and Methods
We conducted a randomized, double-blind, placebo-controlled study to determine whether olanzapine can reduce the frequency of chemotherapy-induced nausea and vomiting (CINV) and improve the quality of life (QOL) in patients receiving palonosetron and dexamethasone as prophylaxis for MEC-induced nausea and vomiting. The primary end point was complete response for the acute phase (0-24 hours after chemotherapy). The secondary end points were complete response for the delayed (24-120 hours) and overall phase (0-120 hours), proportion of significant nausea (visual analogue scale ≥ 25 mm), use ofrescue medications, and effect on QOL.
Results
Fifty-six patients were randomized to the olanzapine (n=29) and placebo (n=27) groups. Complete response rates were not significantly different between the olanzapine and placebo groups in the acute (96.5% vs. 88.0%, p=0.326), delayed (69.0% vs. 48.0%, p=0.118), and overall phases (69.0% vs. 48.0%, p=0.118). However, the percentage of patients with significant nausea (17.2% vs. 44.0%, p=0.032) and the use of rescue medications (0.03±0.19 vs. 1.88±2.88, p=0.002) were lower in the olanzapine group than in the placebo. Furthermore, the olanzapine group demonstrated better QOL (p=0.015).
Conclusion
Olanzapine combined with palonosetron and dexamethasone significantly improved QOL and vomiting control among previously untreated patients receiving MEC, although the efficacy was limited to the reduction of the frequency of CINV.

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Efficacy and safety of multi-day antiemetic treatment for patients undergoing multi-day chemotherapy: a systematic review of Clinical Practice Guidelines for Antiemesis 2023 from Japan Society of Clinical Oncology
Kazuhisa Nakashima, Saki Harashima, Rena Kaneko, Ryuhei Tanaka, Masakazu Abe, Makoto Wada, Keiko Iino, Tatsuo Akechi, Hirotoshi Iihara, Chiyo K. Imamura, Ayako Okuyama, Keiko Ozawa, Yong-il Kim, Eriko Satomi, Masayuki Takeda, Takako Eguchi Nakajima, Naoki
International Journal of Clinical Oncology.2025; 30(1): 17. CrossRef
2020 ASCO, 2023 NCCN, 2023 MASCC/ESMO, and 2019 CCO: a comparison of antiemetic guidelines for the treatment of chemotherapy-induced nausea and vomiting in cancer patients
Samantha K. F. Kennedy, Shannon Goodall, Shing Fung Lee, Carlo DeAngelis, Allison Jocko, Flay Charbonneau, Katie Wang, Mark Pasetka, Yoo-Joung Ko, Henry C. Y. Wong, Adrian Wai Chan, Thenugaa Rajeswaran, Milena Gojsevic, Edward Chow, Richard J. Gralla, Ter
Supportive Care in Cancer.2024;[Epub] CrossRef
A prospective randomized controlled clinical trial investigating the efficacy of low-dose olanzapine in preventing nausea and vomiting associated with oxaliplatin-based and irinotecan-based chemotherapy
Jing Shen, Juan Zhao, Gaowa Jin, Hui Li, Ying Jiang, Yungaowa Wu, Jiali Gao, Feng Chen, Jiaxuan Li, Wenjuan Wang, Quanfu Li
Journal of Cancer Research and Clinical Oncology.2024;[Epub] CrossRef
Health-Related Quality of Life and Economic Analysis of Olanzapine Versus Aprepitant in Preventing Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy in Malaysia
Nurul Suhaida Badarudin, Noraida Mohamed Shah, Nurul Ain Mohd Tahir, Azmi Nor Mohd Farez Ahmat, Fuad Ismail, Farida Islahudin, Suhana Yusak, Syahir Muhammad, Kamarun Neasa Begam Mohd Kassim
Value in Health Regional Issues.2024; 44: 101028. CrossRef
Olanzapine as Antiemetic Prophylaxis in Moderately Emetogenic Chemotherapy
Vikas Ostwal, Anant Ramaswamy, Sarika Mandavkar, Prabhat Bhargava, Deepali Naughane, Sharon Flavia Sunn, Sujay Srinivas, Akhil Kapoor, Bal Krishna Mishra, Anuj Gupta, Bipinesh Sansar, Vikash Pal, Aparajita Pandey, Avinash Bonda, Indraja Siripurapu, Vamshi
JAMA Network Open.2024; 7(8): e2426076. CrossRef
Efficacy and safety of dexamethasone sparing for the prevention of nausea and vomiting associated with moderately emetogenic chemotherapy: a systematic review and meta-analysis of Clinical Practice Guidelines for Antiemesis 2023 from Japan Society of Clin
Kazuhisa Nakashima, Ayako Yokomizo, Michiyasu Murakami, Kenji Okita, Makoto Wada, Keiko Iino, Tatsuo Akechi, Hirotoshi Iihara, Chiyo K. Imamura, Ayako Okuyama, Keiko Ozawa, Yong-il Kim, Hidenori Sasaki, Eriko Satomi, Masayuki Takeda, Ryuhei Tanaka, Takako
International Journal of Clinical Oncology.2024; 29(12): 1785. CrossRef
Can olanzapine preserve life quality in cancer patients undergoing abdominal radiation therapy?
Meenu Vijayan, Sherin Joseph, Haridas M Nair, Debnarayan Dutta, M.P. Narmadha
Medical Hypotheses.2023; 171: 111014. CrossRef
Chemotherapy: how to reduce its adverse effects while maintaining the potency?
Brianna, Sau Har Lee
Medical Oncology.2023;[Epub] CrossRef
The Effect and Safety of Olanzapine on Nausea and Vomiting in Children Receiving Moderately Emetogenic Chemotherapy
Aziz Eghbali, Tahereh Bagherloo, Ali Ghasemi, Roghayeh R. Afzal, Aygin Eghbali, Kazem Ghaffari
Advanced Biomedical Research.2023;[Epub] CrossRef
Olanzapine treatment effectively relieves breakthrough chemotherapy-induced nausea and vomiting: a real-world experience
Akihiro Uchiike, Haruka Kono, Katsuhiro Miura, Tatsuya Hayama, Daisuke Tsutsumi, Shinya Tsuboi, Susumu Ohtsuka, Shinji Hidaka
Journal of Pharmaceutical Health Care and Sciences.2023;[Epub] CrossRef
Supportive care for the prevention of nausea, vomiting and anorexia in a phase 1B study of selinexor in advanced cancer patients: an exploratory study
Rony Dev, Linda L. Zhong, Abdulrazzak Zarifa, Aya A. Albittar, Laura Rubin, Suyu Liu, Timothy A. Yap, Shalini Dalal, David Hui, Daniel D. Karp, Apostolia M. Tsimberidou, Sarina A. Piha-Paul, Jordi Rodon Ahnert, Siqing Fu, Funda Meric-Bernstam, Aung Naing
Investigational New Drugs.2022; 40(1): 124. CrossRef
Interventions for the prevention of acute phase chemotherapy-induced nausea and vomiting in adult and pediatric patients: a systematic review and meta-analysis
Priya Patel, Paula D. Robinson, Nora Wahib, Patrick Cheung, Thomas Wong, Sandra Cabral, Arden Parker, Marie Cohen, Katie Devine, Paul Gibson, Mark T. Holdsworth, Eloise Neumann, Andrea Orsey, Robert Phillips, Daniela Spinelli, Jennifer Thackray, Marianne
Supportive Care in Cancer.2022; 30(11): 8855. CrossRef
Ջոակինո Ռոսինիի «Stabat Mater»-ը Հովհաննես Չեքիջյանի մեկնաբանությամբ (նվիրվում է Ռոսինիի «Stabat Mater»-ի ստեղծման 180-ամյակին և Հայաստանի ազգային ակադեմիական երգչախմբի հիմնադրման 85-ամյակին)
Աննա Ասատրյան
Journal of Art Studies.2022; : 79. CrossRef
Metoclopramide, Dexamethasone, or Palonosetron for Prevention of Delayed Chemotherapy-Induced Nausea and Vomiting After Moderately Emetogenic Chemotherapy (MEDEA): A Randomized, Phase III, Noninferiority Trial
Maurice J.D.L. van der Vorst, Elisa C. Toffoli, Marlien Beusink, Myra E. van Linde, Theo van Voorthuizen, Saskia Brouwer, Annette A. van Zweeden, Suzan Vrijaldenhoven, Johan C. Berends, Johannes Berkhof, Henk M.W. Verheul
The Oncologist.2021; 26(1): e173. CrossRef
Olanzapine for the prophylaxis and rescue of chemotherapy-induced nausea and vomiting: a systematic review, meta-analysis, cumulative meta-analysis and fragility assessment of the literature
Ronald Chow, Jørn Herrstedt, Matti Aapro, Leonard Chiu, Henry Lam, Elizabeth Prsic, Michael Lock, Carlo DeAngelis, Rudolph M. Navari
Supportive Care in Cancer.2021; 29(7): 3439. CrossRef
A phase II study of the safety of olanzapine for oxaliplatin based chemotherapy in coloraectal patients
Junichi Nishimura, Akiko Hasegawa, Toshihiro Kudo, Tomoyuki Otsuka, Masayoshi Yasui, Chu Matsuda, Naotsugu Haraguchi, Hajime Ushigome, Nozomu Nakai, Tomoki Abe, Hisashi Hara, Naoki Shinno, Kei Asukai, Shinichiro Hasegawa, Daisaku Yamada, Keijiro Sugimura,
Scientific Reports.2021;[Epub] CrossRef
The Balance Between the Effectiveness and Safety for Chemotherapy-Induced Nausea and Vomiting of Different Doses of Olanzapine (10 mg Versus 5 mg): A Systematic Review and Meta-Analysis
Dong-Yang Wang, Yi Chen, You Zhang, Ying-Qiang Shen
Frontiers in Oncology.2021;[Epub] CrossRef
A randomized study of olanzapine-containing versus standard antiemetic regimens for the prevention of chemotherapy-induced nausea and vomiting in Chinese breast cancer patients
Winnie Yeo, Thomas KH. Lau, Leung Li, Kwai Tung Lai, Elizabeth Pang, Maggie Cheung, Vicky TC. Chan, Ashley Wong, Winnie MT. Soo, Vanessa TY. Yeung, Teresa Tse, Daisy CM. Lam, Eva WM. Yeung, Kim PK. Ng, Nelson LS. Tang, Macy Tong, Joyce JS. Suen, Frankie K
The Breast.2020; 50: 30. CrossRef
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Kifayat Ullah Khan, Naveed Akhtar, Muhammad Usman Minhas
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Efficacy of Olanzapine-Triple Antiemetic Regimen in Patients with Gastrointestinal Tumor and High Risk of Chemotherapy-Induced Nausea and Vomiting Receiving Moderately Emetogenic Chemotherapy: A Retrospective Study

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Cancer Management and Research.2020; Volume 12: 6575. CrossRef
Efficacy of Olanzapine for High and Moderate Emetogenic Chemotherapy in Children
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Multicenter Retrospective Analysis of Clinical Characteristics, Treatment Patterns, and Outcomes in Very Elderly Patients with Diffuse Large B-Cell Lymphoma: The Korean Cancer Study Group LY16-01: Jung Hye Choi, Tae Min Kim, Hyo Jung Kim, Sung Ae Koh, Yeung-Chul Mun, Hye Jin Kang, Yun Hwa Jung, Hyeok Shim, So Young Chong, Der-Sheng Sun, Soonil Lee, Byeong Bae Park, Jung Hye Kwon, Seung-Hyun Nam, Jun Ho Yi, Young Jin Yuh, Jong-Youl Jin, Jae Joon Han, Seok-Hyun Kim; Cancer Res Treat. 2018;50(2):590-598. Published online June 9, 2017; DOI: https://doi.org/10.4143/crt.2017.172

Abstract PDF PubReader ePub

Purpose
The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data.
Materials and Methods
This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016.
Results
A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patientswas 90.5% (complete response, 41.9%). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8%) and TRT (27.1%). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment.
Conclusion
Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.

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Hematology.2025;[Epub] CrossRef
Mitoxantrone hydrochloride liposome-based chemotherapy plus rituximab in elderly patients older than 80 years with diffuse large B-cell lymphoma: case report and review of the literature
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Will Harris, Edward J. Bataillard, Yoonha Choi, Tarec C. El-Galaly, Vaikunth Cuchelkar, Carsten Henneges, Antonia Kwan, Daniel J. Schneider, Joseph N. Paulson, Tina G. Nielsen
JCO Clinical Cancer Informatics.2022;[Epub] CrossRef
A Multicenter Study of 239 Patients Aged Over 70 Years With Diffuse Large B-Cell Lymphoma in China
Chunli Yang, Qiaoer Li, Ke Xie, Yakun Zhang, Dania Xiang, Yunwei Han, Liqun Zou
Frontiers in Pharmacology.2022;[Epub] CrossRef
Cachexia index as a potential biomarker for cancer cachexia and a prognostic indicator in diffuse large B‐cell lymphoma
Se‐Il Go, Mi Jung Park, Sungwoo Park, Myoung Hee Kang, Hoon‐Gu Kim, Jung Hun Kang, Jung Hoon Kim, Gyeong‐Won Lee
Journal of Cachexia, Sarcopenia and Muscle.2021; 12(6): 2211. CrossRef
Treatment approaches for older and oldest patients with diffuse large B-cell lymphoma – Use of non-R-CHOP alternative therapies and impact of comorbidities on treatment choices and outcome: A Humedica database retrospective cohort analysis, 2007–2015
Vicki A. Morrison, Laurie Hamilton, Augustina Ogbonnaya, Aditya Raju, Kristin Hennenfent, Aaron Galaznik
Journal of Geriatric Oncology.2020; 11(1): 41. CrossRef
Clinical characteristics, treatment patterns and outcomes of patients older than 80 years diagnosed with DLBCL in China over a 10-year period
Zhan Shi, Xi Tang, Qianwen Shen, Jiayan Chen, Fei Liu, Xi Chen, Jingwen Wang, Jie Zhuang
Cancer Chemotherapy and Pharmacology.2019; 84(1): 127. CrossRef
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Reactions Weekly.2018; 1701(1): 32. CrossRef

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