Effectiveness of a single-day three-drug regimen of dexamethasone, palonosetron, and aprepitant for the prevention of acute and delayed nausea and vomiting caused by moderately emetogenic chemotherapy

Grunberg, Steven M.; Dugan, Matthew; Muss, Hyman B.; Wood, M.L.B.; Burdette-Radoux, Susan; Weisberg, Tracey; Siebel, Marisa

doi:10.1007/s00520-008-0535-9

Cited by 79 publications

(57 citation statements)

References 34 publications

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“…[6][7][8][9][10] However, treatmentrelated nausea remains a significant issue. 3,9,11,12 Delayed nausea (DN) is a particular problem and often occurs at rates higher than acute nausea. 2,3,[13][14][15] Patients with breast cancer receiving doxorubicin are especially vulnerable to nausea, and our prior research shows they are more likely to experience DN than patients receiving either cisplatin or carboplatin.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Delayed Nausea: A University of Rochester Cancer Center Community Clinical Oncology Program Study of Patients Receiving Chemotherapy

Roscoe

Heckler

Morrow

et al. 2012

JCO

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Purpose We conducted a double-blind randomized clinical trial of the following four regimens for controlling delayed nausea (DN): group 1: palonosetron + dexamethasone on day 1 with prochlorperazine on days 2 and 3; group 2: granisetron + dexamethasone on day 1 with prochlorperazine on days 2 and 3; group 3: aprepitant + palonosetron + dexamethasone on day 1 with aprepitant + dexamethasone on days 2 and 3; and group 4: palonosetron + dexamethasone on day 1 with prochlorperazine + dexamethasone on days 2 and 3. Patients and Methods Chemotherapy-naive patients received doxorubicin, epirubicin, cisplatin, carboplatin, or oxaliplatin. The primary end point was average nausea assessed four times daily on days 2 and 3. Primary analyses were whether nausea control would be improved by using palonosetron versus granisetron on day 1 (group 1 v group 2); by adding dexamethasone on days 2 and 3 (group 1 v group 4); and by using aprepitant versus prochlorperazine (group 3 v group 4). Statistical significance was set at P = .017. Results Two hundred thirty-four, 234, 241, and 235 evaluable patients were accrued to groups 1, 2, 3, and 4, respectively. Adjusted mean differences for the three planned analyses were as follows: palonosetron versus granisetron: −0.01 (95% CI, −0.23 to 0.20; P = .72); adding dexamethasone on days 2 and 3: 0.20 (95% CI, −0.02 to 0.41; P = .01); and using aprepitant versus prochlorperazine: −0.03 (95% CI, −0.24 to 0.19; P = .56). Conclusion The addition of dexamethasone on days 2 and 3 reduced DN. Palonosetron and granisetron have similar effects on DN. The beneficial effect of adding aprepitant for control of DN was the same as adding prochlorperazine.

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Section: Introductionmentioning

confidence: 99%

Prevention of Delayed Nausea: A University of Rochester Cancer Center Community Clinical Oncology Program Study of Patients Receiving Chemotherapy

Roscoe

Heckler

Morrow

et al. 2012

JCO

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“…Previous studies also reports that the long lasting efficacy of Ramosetron than Granisetron and also half-life of Ramosetron was 5.78 ± 1.18 h whereas that of Granisetron was 3.14 ± 1.20 h. 8 Ramosetron belongs to 5-HT 3 receptor antagonists which is a tetrahydrobenzimidazole derivative structurally different from Granisetron and Ondansetron with more potent 5-HT 3 antagonizing effects. 4,9 It has been proved in many of the articles that antiemetic combinations including Aprepitant are efficacious than those anti-emetic combinations without Aprepitant in the control of emesis because current studies support a three-drug combination of 5-HT 3 antagonists, a corticosteroid and an NK-1 antagonist for the prevention of nausea and vomiting after Cisplatin containing regimens 8,10,11 and moderately emetogenic chemotherapy. Moreover, Aprepitant has shown its efficacy in providing a superior protection against Chemotherapy induced Nausea and Vomiting in adult patients.…”

Section: Discussionmentioning

confidence: 99%

A Study on Evaluation of Anti-Emetics in the Prevention of Chemotherapy Induced Nausea and Vomiting in Cancer Patients in A Tertiary Care Hospital

Paul¹,

Behanan²,

Eapen³

et al. 2017

IJOPP

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Background:The contemporary lifestyle has made Cancer as one of the most deadly diseases. Treatment modalities of cancer are many, while chemotherapy seems to be the most common. Though, chemotherapy subsides the disease, it has many side effects in which Chemotherapy induced Nausea and Vomiting (CINV) is frequent. This study aims to evaluate various antiemetics in the prevention of Chemotherapy induced Nausea and Vomiting in cancer patients specifically in Breast, Lung, Cervix and Head & Neck cancers so that the rate of emesis, efficacy and comparative efficacy of different antiemetic combinations in cancer patients can be determined. Methods: A prospective observational study was carried out at a tertiary care hospital in Tamilnadu, South India between January to June, 2015 in which 241 cancer patients receiving antiemetics in their prescriptions meeting our inclusion criteria were analyzed using standard guidelines. A well designed data collection form was prepared to collect the datas. Results: It was observed from our study that the efficacy of different combination of antiemetics, mostly given as triple based regimen, relied on the treatment regimen of the particular cancer, thereby its emetogenic level and NCI-CTC grading score and it was found out that Ramosetron based triple antiemetic regimen was slightly better than Granisetron based regimen to control CINV. Conclusion: It is the need of the h to promote optimal antiemetic medication and ensure that cancer patient receives evidence-based, effective treatments for their health problems.

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“…However, the prevalence of a CR was only 51% in the aprepitant group and only 42% in the control group over 5 days. Grunberg et al (2009) reported on the efficacy of a triple regimen comprising palonosetron, dexamethasone and aprepitant for prevention of acute and delayed CINV caused by MEC. Prevalence of a CR was relatively good in the acute phase (76%), but was not satisfactory overall (51%).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of triple antiemetic therapy (palonosetron, dexamethasone, aprepitant) for chemotherapy-induced nausea and vomiting in patients receiving carboplatin-based, moderately emetogenic chemotherapy.

Miya

Kobayashi

Hino

et al. 2016

JCO

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Background: Chemotherapy-induced nausea and vomiting (CINV) is a major adverse toxicity of cancer chemotherapy. Recommended treatments for prevention of CINV vary among published guidelines, and optimal care for CINV caused by moderately emetogenic chemotherapy has not been established. This study assessed the efficacy and safety of triple antiemetic therapy comprising palonosetron, dexamethasone and aprepitant for carboplatin-based chemotherapy. Chemotherapy-naïve patients with lung cancer scheduled for a first course of a carboplatin-containing regimen formed the study cohort. Patients were pretreated with antiemetic therapy comprising palonosetron (0.75 mg, i.v.) and dexamethasone (9.9 mg, i.v.) on day 1, and aprepitant (125 mg, p.o.) on day 1 followed by 80 mg on days 2 and 3. Primary endpoint was the proportion of patients who did not experience vomiting and did not require rescue medication [complete response (CR)] in the acute phase (0-24 h), late phase (24-168 h) and overall. Secondary endpoint was the proportion of patients who experienced no vomiting episodes and no more than mild nausea without the need for rescue medication [complete control (CC)].Results: Prevalence of a CR during the acute phase, delayed phase, and overall was 100, 91.9 and 91.9%, whereas that of CC was 100, 84.4 and 84.4%, respectively. The most common adverse event was mild constipation; severe adverse events related to antiemetic treatment were not observed. Conclusion: Triple antiemetic therapy comprising palonosetron, dexamethasone and aprepitant shows excellent effects in the prevention of CINV in patients receiving a carboplatin-containing regimen.

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Effectiveness of a single-day three-drug regimen of dexamethasone, palonosetron, and aprepitant for the prevention of acute and delayed nausea and vomiting caused by moderately emetogenic chemotherapy

Abstract: A single-day three-drug antiemetic regimen is feasible and effective for protection against both Acute and Delayed vomiting after moderately emetogenic chemotherapy. Formal comparison to a standard multi-day antiemetic regimen is warranted.

Cited by 79 publications

References 34 publications

Prevention of Delayed Nausea: A University of Rochester Cancer Center Community Clinical Oncology Program Study of Patients Receiving Chemotherapy

Prevention of Delayed Nausea: A University of Rochester Cancer Center Community Clinical Oncology Program Study of Patients Receiving Chemotherapy

A Study on Evaluation of Anti-Emetics in the Prevention of Chemotherapy Induced Nausea and Vomiting in Cancer Patients in A Tertiary Care Hospital

Efficacy of triple antiemetic therapy (palonosetron, dexamethasone, aprepitant) for chemotherapy-induced nausea and vomiting in patients receiving carboplatin-based, moderately emetogenic chemotherapy.

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