Consensus Proposal for 5-HT3 Antagonists in the Prevention of Acute Emesis Related to Highly Emetogenic Chemotherapy

Gandara, David R.; Roila, Fausto; Warr, David; Edelman, Martin J.; Perez, Edith A.; Gralla, Richard J.

doi:10.1007/978-3-642-72137-3_6

Cited by 13 publications

(15 citation statements)

References 45 publications

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“…Despite an expert panel 5 and nonsystematic reviews of the literature 3,4 indicating that there seems to be no superior serotonin antagonist for the prevention of chemotherapy-induced nausea and vomiting, to our knowledge, no formal meta-analysis has ever been conducted to corroborate this position. Therefore, we attempted to systematically review all the data from randomized controlled trials that addressed whether granisetron was superior to ondansetron for the prophylaxis of chemotherapy-induced nausea and vomiting.…”

Section: Discussionmentioning

confidence: 99%

“…2 Whereas these new medications are better than the older conventional antiemetics 1 in the prevention of radiationinduced nausea and vomiting, there was no evidence of any of these new antiemetic medications being superior to one another. 2 Regarding the prevention of chemotherapy-induced nausea and vomiting, conclusions of nonsystematic reviews [3][4][5] as well as those of a recently conveyed expert panel by the American Society of Clinical Oncology coincide regarding the lack of superiority of one serotonin antagonist antiemetic drug over another. However, to our knowledge, no systematic review of all randomized trials that address this question has been conducted yet.…”

mentioning

confidence: 99%

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Granisetron is equivalent to ondansetron for prophylaxis of chemotherapy-induced nausea and vomiting

Giglio

Soares

Caparroz

et al. 2000

Cancer

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Granisetron is equivalent to ondansetron for prophylaxis of chemotherapy-induced nausea and vomiting

Giglio

Soares

Caparroz

et al. 2000

Cancer

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“…2 The issue of "down-dosing"-that is, the administration of these drugs at lower doses than rec- ommended by the package insert-is particularly pertinent, because the 5-HT 3 receptor antagonists have a very steep dose-response curve within a narrow dose range. 18 This implies that control of emesis will be lost suddenly as doses are reduced (Fig. 1).…”

Section: The Dangers Of Suboptimal Dosingmentioning

confidence: 99%

5‐hydroxytryptamine type‐3 receptor antagonists for chemotherapy‐induced and radiotherapy‐induced nausea and emesis

Aapro

Blower

2005

Cancer

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BACKGROUNDNausea and emesis as a consequence of chemotherapy or radiotherapy can have an adverse effect on patients' quality of life during cancer treatment and may last for > 5 days after administration. Guidelines suggest that, used at appropriate doses, the 5‐hydroxytryptamine type‐3 (5‐HT3) receptor antagonists—which are considered the antiemetic “gold standard” when they are administered in combination with corticosteroids—demonstrate equivalent efficacy and safety. However, due to financial considerations, these agents often are used at lower doses than recommended.METHODSA literature review of relevant publications pertaining to the control of chemotherapy‐induced nausea and emesis and dosing issues of the 5‐HT3 receptor antagonists was undertaken to provide a comprehensive review of dosing issues relevant to the 5‐HT3 receptor antagonists.RESULTSThe issue of “down dosing” was particularly pertinent because of the nature of the 5‐HT3 receptor antagonist dose‐response curve: A steep dose‐response profile within a narrow dose range suggests that antiemetic control will be lost suddenly after dose deescalation. However, the array of predisposing and confounding patient factors indicates that it is unlikely that a loss of antiemetic control will be apparent across a population; rather, individuals will experience loss of control as the dose is reduced below threshold. Of the 4 5‐HT3 receptor antagonists currently licensed in the United States (granisetron, ondansetron, dolasetron, and palonosetron), ondansetron is used sometimes at lower than optimal doses, and there is evidence to suggest that even the approved oral dose of dolasetron may be suboptimal.CONCLUSIONSSuboptimal dosing not only will be detrimental to patients' quality of life but, ultimately, will prove counterproductive in terms of hospital resources, and it will add to the already significant socioeconomic burden associated with cancer therapy. Therefore, the dose of antiemetic agent administered should be sufficiently high to ensure good emesis control across the whole patient population. Cancer 2005. © 2005 American Cancer Society.

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“…injection, which might constitute a bias for overall interpretation. Nonetheless, according to Multinational Association of Supportive Care in Cancer guidelines [4], in clinical practice, p.o. ondansetron administration represents a valid alternative to the i.m.…”

Section: P=0003mentioning

confidence: 99%

Oral ondansetron is highly active as rescue antiemetic treatment for moderately emetogenic chemotherapy: results of a randomized phase II study

Fabi¹,

Ciccarese²,

Metro³

et al. 2008

Support Care Cancer

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Consensus Proposal for 5-HT3 Antagonists in the Prevention of Acute Emesis Related to Highly Emetogenic Chemotherapy

Cited by 13 publications

References 45 publications

Granisetron is equivalent to ondansetron for prophylaxis of chemotherapy-induced nausea and vomiting

Granisetron is equivalent to ondansetron for prophylaxis of chemotherapy-induced nausea and vomiting

5‐hydroxytryptamine type‐3 receptor antagonists for chemotherapy‐induced and radiotherapy‐induced nausea and emesis

Oral ondansetron is highly active as rescue antiemetic treatment for moderately emetogenic chemotherapy: results of a randomized phase II study

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