Olanzapine for nausea and vomiting in people with breast cancer treated with trastuzumab deruxtecan: plain language summary of the ERICA study

Future Oncol. 2025 Nov;21(27):3459-3475. doi: 10.1080/14796694.2025.2566329. Epub 2025 Oct 24.
No abstract available

Keywords: breast cancer; nausea; olanzapine; plain language summary; vomiting.

Plain language summary

What is this summary about?This is a summary describing the results from a study called ERICA. We evaluated the efficacy of an olanzapine-based triplet regimen for preventing nausea and vomiting in people receiving their first cycle of trastuzumab deruxtecan (also called ‘T-DXd’) in Japan. The study period was 21 days from the first dose of trastuzumab deruxtecan.What were the results?Participants with HER2-positive or HER2-low metastatic breast cancer who had been treated with trastuzumab deruxtecan as the first administration were included in the study. Participants in the olanzapine group, who received combination treatment with three drugs (olanzapine + serotonin receptor antagonist [also called a serotonin receptor blocker] + dexamethasone) to prevent nausea and vomiting during their first cycle, had fewer episodes of nausea and vomiting than participants in the placebo group, who received a combination of placebo + serotonin receptor antagonist + dexamethasone. Adverse events were observed during treatment with olanzapine, but there were few severe adverse events and no major safety problems.What do the results mean?The combination of ‘olanzapine + serotonin receptor antagonist + dexamethasone’ appears to be useful in preventing prolonged nausea and vomiting during the first cycle of trastuzumab deruxtecan treatment in people with HER2-positive and HER2-low metastatic breast cancer.Clinical trial number: 254973216.