A retrospective study of R-CHOP/CHOP therapy-induced nausea and vomiting in non-Hodgkin’s lymphoma patients: a comparison of intravenous and oral 5-HT3 receptor antagonists

Abstract

Chemotherapy-induced nausea and vomiting (CINV) is a serious problem for cancer patients receiving chemotherapy. The CHOP regimen is the standard treatment for non-Hodgkin's lymphoma (NHL) and is categorized as highly or moderately emetogenic in the CINV guidelines. The efficacy of oral 5-HT3 receptor antagonists is equivalent to that of the intravenous form in patients with solid tumors, but there is no clear comparative data for the use of these agents NHL patients receiving CHOP. We analyzed retrospective CINV data from medical records of 72 NHL patients who received CHOP or rituximab-combined CHOP therapy (R-CHOP). All patients received 5-HT3 receptor antagonists alone for prevention of CINV; 39 of the patients received an intravenous form (mostly granisetron) and 33 an oral form (all ramosetron). Complete response (CR: defined as no vomiting and no rescue therapy) was observed in 58 of 72 patients (80.6 %) overall (0-120 h post-CHOP). The CR rate was not statistically different in patients treated with oral or intravenous 5-HT3 receptor antagonists (82.1 vs 78.8 %, P = 0.77). These findings suggest that oral 5-HT3 receptor antagonists represent a good alternative to intravenous forms in NHL receiving CHOP/R-CHOP chemotherapy. Further studies are needed to identify the optimal anti-emetic supportive therapy for NHL.

Granisetron plus aprepitant versus granisetron in preventing nausea and vomiting during CHOP or R-CHOP regimen in malignant lymphoma: a retrospective study

“…These results suggest that granisetron only could be one treatment option in patients with non-Hodgkin lymphoma who have received CHOP or R-CHOP regimen. In a previous study, Takahashi et al performed a retrospective study to evaluate the effects of oral and intravenous first-generation 5-HT3 receptor antagonists (ondansetron) in patients with non-Hodgkin lymphoma who received R-CHOP or CHOP regimen [9]. They reported that the CR rate did not differ between the two groups (overall: 82.1% vs. 78.8%, p = 0.77; acute phase: 87.2% vs. 90.9%, p = 0.72; delayed phase: 84.6% vs. 81.8%, p = 0.76), suggesting that ramosetron is one of the optimal options for preventing CINV in patients treated with CHOP or R-CHOP regimen.…”