olanzapine + neurokinin-1 receptor antagonist + serotonin 5-HT3 receptor antagonist

This investigational combination therapy consists of olanzapine, a neurokinin-1 (NK-1) receptor antagonist, and a serotonin 5-HT3 receptor antagonist. It is being evaluated by the Fifth Affiliated Hospital, Sun Yat-Sen University, as a dexamethasone-free antiemetic regimen for the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving highly emetogenic, cisplatin-based chemotherapy. Olanzapine is an atypical antipsychotic that acts as a multi-receptor antagonist, targeting dopamine, serotonin, histamine, and muscarinic receptors, which helps suppress both acute and delayed emesis. The NK-1 receptor antagonist (such as aprepitant or fosaprepitant) inhibits the binding of substance P to neurokinin receptors, while the 5-HT3 receptor antagonist (such as ondansetron) blocks serotonin-mediated signaling in the peripheral and central nervous systems. This triplet regimen aims to provide non-inferior efficacy to standard dexamethasone-containing protocols while avoiding corticosteroid-related side effects like hyperglycemia and insomnia.

Other names

olanzapine + NK-1 RA + 5-HT3 RAolanzapine-containing triplet antiemetic regimendexamethasone-free antiemetic protocol