Efficacy of palonosetron and 1-day dexamethasone in moderately emetogenic chemotherapy compared with fosaprepitant, granisetron, and dexamethasone: a prospective randomized crossover study

Kitayama, Hitoshi; Tsuji, Yasushi; Sugiyama, Junko; Doi, Ayako; Kondo, Tomohiro; Hirayama, Michiaki

doi:10.1007/s10147-015-0823-6

Cited by 19 publications

(16 citation statements)

References 18 publications

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“…We identified 1,613 records about CINV through database searching and focused on 61 potentially relevant randomized control trials with olanzapine‐based triple regimens or NK‐1RAs‐base triple regimens in the experimental arm. However, 18 trials were not eligible for the following reasons: associating with MEC , using nonstandard triple CINV regimens , unavailable measured outcomes , carboplatin area under the curve remain unclear , and using quadruplex antiemetic regimens in the experimental arm . We finally included 42 trials focused on HEC involving 16,609 cancer patients using olanzapine‐based triple regimens (olanzapine + 5‐HT 3 RA + dexamethasone, n = 657), NK‐1Ras‐based triple regimens (NK‐1RAs + 5‐HT 3 RA + dexamethasone, n = 10,510), or conventional duplex control regimens (5‐HT 3 RA + dexamethasone, n = 5,442) to control CINV in this network meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

Olanzapine-Based Triple Regimens Versus Neurokinin-1 Receptor Antagonist-Based Triple Regimens in Preventing Chemotherapy-Induced Nausea and Vomiting Associated with Highly Emetogenic Chemotherapy: A Network Meta-Analysis

Zhang

Chen

et al. 2018

The Oncologist

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According to the results of this study, olanzapine-based triple antiemetic regimens were superior in both overall and delayed-phase nausea control when compared with various neurokinin-1 receptor antagonists-based triple regimens in patients with highly emetogenic chemotherapy (HEC). Olanzapine-based triplet was outstanding in terms of nausea control and drug price. For cancer patients with HEC, especially those suffering from delayed-phase nausea, olanzapine-based triple regimens should be an optional antiemetic choice.

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Section: Resultsmentioning

confidence: 99%

Olanzapine-Based Triple Regimens Versus Neurokinin-1 Receptor Antagonist-Based Triple Regimens in Preventing Chemotherapy-Induced Nausea and Vomiting Associated with Highly Emetogenic Chemotherapy: A Network Meta-Analysis

Zhang

Chen

et al. 2018

The Oncologist

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“…Regarding vomiting, a study comparing two-drug (palonosetron+DEX) and three-drug combinations (NK1RA + first-generation 5HT3RA + DEX) for an L-OHP-based regimen showed the rates of no vomiting in the acute and delayed phases to be 99.4 and 95.5%, respectively, with the 2-drug combination [28]. Our rates of no vomiting in the acute and delayed phases in the two-drug group (palonosetron+DEX) were 95.9 and 96.9%, respectively, which were almost the same as in that previous study.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the combination use of aprepitant and palonosetron for improving nausea in various moderately emetogenic chemotherapy regimens

Yoshida

Taguchi

Nakanishi

et al. 2019

BMC Pharmacol Toxicol

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BackgroundNausea is more difficult to control than vomiting in chemotherapy. We therefore analyzed the efficacy of a strong supportive treatment with aprepitant, palonosetron, and dexamethasone against nausea for various moderately emetogenic chemotherapy (MEC).MethodsA total of 312 cases treated by palonosetron with or without aprepitant receiving MEC regimens using oxaliplatin, carboplatin, and irinotecan from 2014 to 2016 in our outpatient center for digestive organ cancers, lung cancers, and gynecological cancers were analyzed. Through propensity score matching analysis, cases were divided into 97 cases receiving 2 drugs (palonosetron+dexamethasone) and 97 receiving 3 drugs (aprepitant+palonosetron+dexamethasone). We examined the control rates of nausea for the first two consecutive courses in the both groups. Additionally, risk factors for acute and delayed nausea were analyzed using a multivariate analysis among overall 312 cases.ResultsThe control rates of nausea in the two- and the three-drug groups were as follows: acute, 92.8 and 95.9% (p = 0.35); and delayed, 83.5 and 81.4% (p = 0.85), although the control rates of vomiting exceeded 95% in both groups. A multivariate analysis showed that significant risk factors for acute nausea (odds ratio, 95% confidence interval) were elevation of serum creatinine (12.601, 2.437–65.157), general fatigue (3.728, 1.098–12.661), and performance status (PS) 2 (19.829, 3.200–122.865). The significant risk factors for delayed nausea were elevation of alanine aminotransferase (2.397, 1.153–4.984), general fatigue (2.652, 1.380–5.097), and PS 2 (5.748, 1.392–23.740).ConclusionsThe control for nausea in MEC was insufficient even with palonosetron and aprepitant, and we should pay attention to risk factors for preventing nausea.

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“…Randomized controlled trials in patients receiving MEC are summarized in Table 6 . 38 , 70 – 72 , 74 – 82 About half the MEC trials tabulated reported no significant improvements in nausea control in any CINV phase with the addition of an NK 1 RA to a two-drug antiemetic regimen. Of those that did report a significant improvement in nausea control in any phase, 70 – 72 , 75 , 76 , 79 , 80 none showed significant improvements in nausea control across the acute, delayed, and overall phases.…”

Section: Pharmacokinetic Receptor Occupancy and Pharmacodynamic Promentioning

confidence: 99%

Evolving role of neurokinin 1-receptor antagonists for chemotherapy-induced nausea and vomiting

Navari¹,

Schwartzberg²

2018

OTT

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To examine pharmacologic and clinical characteristics of neurokinin 1 (NK1)-receptor antagonists (RAs) for preventing chemotherapy-induced nausea and vomiting (CINV) following highly or moderately emetogenic chemotherapy, a literature search was performed for clinical studies in patients at risk of CINV with any approved NK1 RAs in the title or abstract: aprepitant (capsules or oral suspension), HTX019 (intravenous [IV] aprepitant), fosaprepitant (IV aprepitant prodrug), rolapitant (tablets or IV), and fixed-dose tablets combining netupitant or fosnetupi-tant (IV netupitant prodrug) with the 5-hydroxytryptamine type 3 (5HT3) RA palonosetron (oral or IV). All NK1 RAs are effective, but exhibit important differences in efficacy against acute and delayed CINV. The magnitude of benefit of NK1-RA-containing three-drug vs two-drug regimens is greater for delayed vs acute CINV. Oral rolapitant has the longest half-life of available NK1 RAs, but as a consequence should not be administered more frequently than every 2 weeks. In general, NK1 RAs are well tolerated; however, IV rolapitant was recently removed from US distribution, due to hypersensitivity and anaphylaxis, and IV fosaprepitant is associated with infusion-site reactions and hypersensitivity presumed related to its polysorbate 80 excipient. Also, available NK1 RAs have potential drug–drug interactions. Adding an NK1 RA to 5HT3 RA and dexamethasone significantly improves CINV control vs the two-drug regimen. Newer NK1 RAs offer more formulation options, higher acute-phase plasma levels, or improved tolerability, and increase clinicians’ opportunities to maximize benefits of this important class of antiemetics.

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Efficacy of palonosetron and 1-day dexamethasone in moderately emetogenic chemotherapy compared with fosaprepitant, granisetron, and dexamethasone: a prospective randomized crossover study

Abstract: PALO and 1-day DEX is almost equivalent to FAPR, GRAN, and DEX for MEC.

Cited by 19 publications

References 18 publications

Olanzapine-Based Triple Regimens Versus Neurokinin-1 Receptor Antagonist-Based Triple Regimens in Preventing Chemotherapy-Induced Nausea and Vomiting Associated with Highly Emetogenic Chemotherapy: A Network Meta-Analysis

Olanzapine-Based Triple Regimens Versus Neurokinin-1 Receptor Antagonist-Based Triple Regimens in Preventing Chemotherapy-Induced Nausea and Vomiting Associated with Highly Emetogenic Chemotherapy: A Network Meta-Analysis

Efficacy of the combination use of aprepitant and palonosetron for improving nausea in various moderately emetogenic chemotherapy regimens

Evolving role of neurokinin 1-receptor antagonists for chemotherapy-induced nausea and vomiting

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