Antiemetic Efficacy of an Oral Suspension of Granisetron plus Dexamethasone and Influence of Quality of Life on Risk for Nausea and Vomiting

Abstract

Objectives: To assess the antiemetic efficacy of an oral suspension of granisetron/dexamethasone in patients receiving chemotherapy and to determine whether quality-of-life parameters influence the risk for postchemotherapy nausea and vomiting (PCNV). Patients and Methods: In an open monocentric study, an oral suspension containing 2 mg granisetron and 16 mg (4 mg for moderately emetogenic chemotherapy) dexamethasone was administered to 43 chemotherapy-naive patients before highly (n = 16) or moderately (n = 27) emetogenic chemotherapy and on the 3 subsequent days (2 for moderately emetogenic chemotherapy). Emetic episodes were recorded and quality of life was assessed prior to each cycle with a questionnaire based on EORTC QLQ-30. Results: In the group undergoing highly (moderately) emetogenic chemotherapy, complete control of acute vomiting was achieved in 60-72.7% (92.6-95.0% ), and complete control of delayed vomiting in 37.5-40.0% (75.0-92.2% ), of patients within the first 3 (5) cycles. The following quality-of-life parameters were significantly associated with PCNV: tiredness (RR = 1.3, p < 0.05), pain (RR = 1.5), impairment of daily life by pain (RR= 1.7), sensation of abdominal pressure and fullness (RR = 2.5), impairment of social activities (RR = 2.9). Conclusions: Once-daily oral administration of a suspension of granisetron/dexamethasone is an active prophylaxis of nausea and vomiting and compares favorably with data reported on intravenous administration. Quality-of-life parameters assessed pre-treatment could help to identify patients at high risk for nausea and vomiting so that antiemetic therapy can be tailored to individual patient risk.

The Effect of a Complex Healing Treatment on 2-Year Survival Rate of Patients With Malignant Tumors

“…Along with the intervention group, the control group was simultaneously receiving professional advice from doctors on countermeasures, routine follow-up in the hospital, and gradual recovery of lesions deriving from disease and treatment. 9 In patients with stage 2 tumors, the survival rate in the intervention group was 94.74% (108/114), whereas it was 80.67% in the control group (P < .01). There is thus a striking difference between groups, which indicates that the complex healing intervention affects survival rate in this stage.…”

Use of granisetron transdermal system in the prevention of chemotherapy-induced nausea and vomiting: a review

“…According to available literature, the usual rate of emesis control in chemotherapy with moderate or high emetic potential using 5-HT 3 receptor antagonists is between 40% and 86%. [59][60][61][62][63][64] The higher rates of emesis control in moderately emetogenic chemotherapy are achieved with 2-drug regimens combining 5-HT 3 antagonists and dexamethasone (75% in acute emesis and 92% in delayed emesis). 6,59,60 In highly emetogenic chemotherapy, the higher rates of emesis control are achieved with 3-drug regimens combining 5-HT 3 antagonists, dexamethasone, and aprepitant (83% to 93% in acute emesis and 79% to 76% in delayed emesis).…”

“…6,27,28,64,[68][69][70] The clinical trials that included specifically granisetron combined with dexamethasone reported a rate of complete emesis control in 60% and 86% of patients, higher than the 70% with intravenous granisetron, 61 and 60% to 86% with oral granisetron. [62][63][64] A recent phase III clinical trial comparing palonosetron plus dexamethasone with intravenous granisetron plus dexamethasone in highly emetogenic chemotherapy reported a 73.3% complete response with granisetron plus dexamethasone. 42 It is not possible compare these findings (2-or 3-drug regimens) with the results of transdermal granisetron trials, because only granisetron monotherapy was used.…”

Use of granisetron transdermal system in the prevention of chemotherapy-induced nausea and vomiting: a review

“…In highly emetogenic chemotherapy, the higher rates of emesis control are achieved with 3-drug regimens combining 5-HT 3 antagonists, dexamethasone, and aprepitant (83% to 93% in acute emesis and 79% to 76% in delayed emesis) 6,27,28,64,68–70. The clinical trials that included specifically granisetron combined with dexamethasone reported a rate of complete emesis control in 60% and 86% of patients, higher than the 70% with intravenous granisetron,61 and 60% to 86% with oral granisetron 62–64. A recent phase III clinical trial comparing palonosetron plus dexamethasone with intravenous granisetron plus dexamethasone in highly emetogenic chemotherapy reported a 73.3% complete response with granisetron plus dexamethasone 42…”