Olanzapine enhances the response of PD-(L)1 inhibitor immunotherapy: A retrospective efficacy analysis in advanced malignancies
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Objectives This retrospective cohort study explores olanzapine’s immunomodulatory role and clinical impact in advanced cancer patients on PD-(L)1 inhibitors, given chronic stress may impair immune checkpoint inhibitor efficacy. Methods Among 1933 advanced cancer patients receiving PD-(L)1 inhibitors + chemotherapy (2018–2022), 99 received concurrent olanzapine for chemotherapy induced nausea. After excluding 58 cases, 41 olanzapine-treated patients were propensity score-matched (PSM) for age, gender, and cancer type. Survival outcomes were analyzed via Kaplan–Meier curves and log-rank tests. Results The olanzapine cohort showed higher ORR (39.02% vs. 26.83%), comparable median PFS (9 vs. 6 months, P = 0.057), and significantly longer median OS (28 vs. 9 months, P = 0.019). Multivariate analysis confirmed olanzapine correlated with prolonged OS (HR = 0.510, 95% CI:0.282–0.917, P = 0.026). Conclusions Olanzapine may enhance survival benefits in advanced cancer patients undergoing PD-(L)1 inhibitor therapy.
