Emesis as a Critical Problem in Chemotherapy

László, John; Lucas, Virgil S.

doi:10.1056/nejm198110153051609

Cited by 140 publications

(34 citation statements)

References 4 publications

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“…[1][2][3] Adult patients in whom CINV is left uncontrolled experience a severe deterioration in their quality of life and may experience malnourishment, anxiety, and depression. Fear of CINV is sufficient for many patients to postpone or even refuse potentially life-saving treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Fear of CINV is sufficient for many patients to postpone or even refuse potentially life-saving treatment. [3][4][5][6] However, antiemetics can improve quality of life, increase treatment compliance and effectiveness, and therefore improve patient outcome. [7][8][9] Antiemetics counter CINV by antagonising the 5-hydroxytryptamine subtype 3 (5-HT 3 ) receptor or the neurokinin-1 (NK 1 ) receptor.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9] Antiemetics counter CINV by antagonising the 5-hydroxytryptamine subtype 3 (5-HT 3 ) receptor or the neurokinin-1 (NK 1 ) receptor. Currently, in adult patients undergoing highly emetogenic chemotherapy, the administration of a 5-HT 3 receptor antagonist alongside the NK 1 receptor antagonist, aprepitant, and dexamethasone is recommended for the treatment of acute CINV. 10,11 For patients undergoing a moderately emetogenic chemotherapy regimen, palonosetron hydrochloride (Aloxi®, palonosetron; a 5- In paediatric patients, at the time of study design, Multinational Association of Supportive Care in Cancer (MASCC) and European Society for Medical Oncology (ESMO) guidelines recommended prophylactic antiemetic therapy comprising a 5-HT 3 receptor antagonist and dexamethasone to prevent acute CINV in patients scheduled to receive moderately or highly emetogenic chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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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

Kovács

Wachtel

Basharova

et al. 2016

The Lancet Oncology

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

Kovács

Wachtel

Basharova

et al. 2016

The Lancet Oncology

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“…It improves patient quality of life by reducing the intensity and the number of side-effects and therefore reduces length of hospitalisation and treatment costs (Laszlo & Lucas, 1981).…”

mentioning

confidence: 99%

Dose finding study of granisetron in patients receiving high-dose cisplatin chemotherapy

Rivière

1994

Br J Cancer

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Summary The efficacy and safety of three different doses of granisetron (2pjgkg-', group A; 10;Lgkg-', group B; 40jiygkg-', group C) were compared in a randomised, double-blind study of 157 patients due to receive high-dose cisplatin therapy (mean dose >97 mg m-2). In each group, up to two 3 mg rescue doses of granisetron were allowed if more than mild nausea or vomiting occurred. In group A 30.8%, in group B 61.5% and in group C 67.9% of patients were complete responders (i.e. no vomiting or nothing worse than mild nausea) during the first 24 h. These differences are significant between groups A and B, and A and C. There were no statistically significant differences in any efficacy variable between the 10 g kg-' and 40 jig kg-groups, although in each case the trend favoured the higher dose. Additional rescue doses resulted in resolved or improved symptoms in 95.3% for the first rescue dose and 93.3% for the second. Over the 7 days of the study, 82.7%, 82.7% and 86.8% of patients in groups A, B and C respectively were treated with granisetron alone. Headache was the most common side-effect, reported by 9.6% of patients; the majority of headaches were mild. There was no difference between the treatment groups regarding the adverse event rate. We concluded that prophylactic doses of 10 or 40 jig kg-' lead to a safe and satisfactory degree of control of nausea and vomiting induced by high-dose cisplatin.

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“…Nausea and vomiting are the most common and potentially grave complications of anticancer therapy (Laszlo & Lucas, 1981;Morran et al, 1979;Seigel & Long, 1981). Moreover, emesis is an important limiting factor in the administration of cytotoxic therapy (Seigel & Long, 1981).…”

mentioning

confidence: 99%

Antiemetic efficacy of high-dose dexamethasone: Randomized, double-blind, crossover study with a combination of dexamethasone, metoclopramide and diphenhydramine

Al‐Idrissi

Ibrahim²,

Abdullah³

et al. 1988

Br J Cancer

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Silmmary A double-blind, randomized, crossover study was conducted to compare the efficacy and safety of high-dose dexamethasone (Protocol D) with a combination of dexamethasone, metoclopramide and diphenhydramine (Protocol DMD) in the management of chemotherapy-induced nausea and vomiting in cancer patients. All entered patients had received no prior chemotherapy. During the study chemotherapy was administered on an inpatient basis. The majority of patients (94%) were treated with cytotoxic drugs of significant emetogenic activity and 40% of the study group received cis-platin-containing combinations.Of DMD and 9 (15%) found no difference between the two regimens.We conclude that, while the short DMD protocol has an antiemetic activity equivalent in its effectiveness to D, its associated adverse reactions would minimize its usefulness. Therefore, further investigations should be conducted to find a safer and more potent combination of antiemetics suitable for therapy in an outpatient setting.Nausea and vomiting are the most common and potentially grave complications of anticancer therapy (Laszlo & Lucas, 1981;Morran et al., 1979;Seigel & Long, 1981). Moreover, emesis is an important limiting factor in the administration of cytotoxic therapy (Seigel & Long, 1981). Total prevention of chemotherapy-induced nausea and vomiting is paramount in improving patients' acceptance of cytotoxic drugs.Various groups of antiemetics with varying degree of efficacy and modes of action have been tested (Laszlo, 1983;Moertel & Reitemeier, 1969;Moertel et al., 1963;Wampler, 1983). Dexamethasone has been shown to exhibit significant antiemetic activity in the past few years (Aapro & Plezia, 1983;Cassileth et al., 1983Cassileth et al., ,1984Markman et al., 1984). Recently also, in a randomized, double-blind, crossover study, we demonstrated conclusively that high-dose dexamethasone is more effective as an antiemetic and safer than high-dose metoclopramide in patients who are mainly receiving non-cis-platin emetogenic chemotherapy (Ibrahim et al., 1986). However, the dosages and schedule of the antiemetics used in that trial were not suitable for outpatient management.The administration of combinations of antiemetic drugs which would act at different receptor sites should improve their antiemetic potential through complete neuroreceptor blockade (Bruera et al., 1983;Krebs et al., 1985;Mason et al., 1982;Morran et al., 1979). Furthermore, combining two or more antiemetics should minimise the adverse effects produced by the constituent agents given singly in higher doses. The efficacy and safety of a short course of the combination of dexamethasone, metoclopramide and diphenhydramine (Protocol DMD) have been demonstrated recently (Kris et al., 1985). However, the DMD regimen has never been tested in a double-blind and randomized trial against the well established antiemetic protocols.We now present the outcome of a randomized, doubleblind, crossover study comparing the effectiveness of highdose dexamethasone (Protocol D) with a short...

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Emesis as a Critical Problem in Chemotherapy

Cited by 140 publications

References 4 publications

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

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

Dose finding study of granisetron in patients receiving high-dose cisplatin chemotherapy

Antiemetic efficacy of high-dose dexamethasone: Randomized, double-blind, crossover study with a combination of dexamethasone, metoclopramide and diphenhydramine

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