Acute effect of palonosetron on electrocardiographic parameters in cancer patients: a prospective study

Abstract

Palonosetron seems to have no acute arrhythmogenic potential.

Palonosetron versus ondansetron for prevention of chemotherapy-induced nausea and vomiting in paediatric patients with cancer receiving moderately or highly emetogenic chemotherapy: a randomised, phase 3, double-blind, double-dummy, non-inferiority study

“…13,14,[21][22][23][24] Palonosetron has been shown not to cause arrhythmias or symptomatic electrocardiographic changes. [25][26][27] The present study was designed to assess the efficacy and safety of two intravenous doses of palonosetron (10 and 20 µg/kg) in paediatric patients with cancer aged from new-born (full term; ≥37 weeks) to <17 years, scheduled to undergo moderately or highly emetogenic chemotherapy. The primary objective of this study was to demonstrate in paediatric patients the non-inferiority of palonosetron, versus ondansetron, during the acute phase of the first on-study chemotherapy cycle.…”

Palonosetron versus older 5-HT3 receptor antagonists for nausea prevention in patients receiving chemotherapy: a multistudy analysis

“…With respect to laboratory values, vital signs, and ECG findings, there were no pronounced differences between palonosetron and older 5-HT 3 RAs. The studies analyzed here did not thoroughly evaluate QTc measures; however, recent studies in patients with cancer 17,18 and a thorough QTc study in healthy subjects that used a positive control (ie, moxifloxacin) 16 demonstrated no significant QTc changes associated with palonosetron. This is in contrast to evidence of significant dose-related QTc prolongation with ondansetron, which led to the removal of the 32-mg single dose from its label, 30 and an increased risk of cardiac arrhythmias with IV dolasetron, which is no longer recommended.…”

Efficacy benefit of an NK1 receptor antagonist (NK1RA) in patients receiving carboplatin: supportive evidence with NEPA (a fixed combination of the NK1 RA, netupitant, and palonosetron) and aprepitant regimens

“…As the first combination antiemetic developed, it targets two critical molecular pathways (substance P/NK 1 RA; serotonin/5-HT 3 RA) associated with CINVand offers guidelineconsistent prophylaxis with a single dose (and DEX). Palonosetron was selected for the combination over older generation 5-HT 3 RAs due to its distinctive pharmacological properties [20,21], safe cardiac profile [22][23][24][25], and proven clinical efficacy [26][27][28][29]. In mechanistic studies, netupitant and palonosetron have exhibited synergistic effects when inhibiting the substance P response [30].…”