Is Navoban® (tropisetron) as effective as Zofran® (ondansetron) in cisplatin-induced emesis?

Marty, Michel; Kleisbauer, J. P.; Fournel, P.; Vergnenègre, A.; Carlès, Pierre; Loria-Kanza, Y; Simonetta, C; Bruijn, K M de

doi:10.1097/00001813-199502001-00004

Cited by 32 publications

(15 citation statements)

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“…Prior to that time, high doses of metoclopramide were used to combat cisplatin-induced nausea and vomiting. However, while these partially suppressed symptoms, as many as 30%-60% of patients continued to suffer nausea and vomiting, and extrapyramidal effects associated with dopamine (D 2 ) antagonism occurred in up to 5% of patients [35]. A greater understanding of the pathophysiology of emesis disclosed the importance of serotonin (5-HT) in the mediation of the emetic response.…”

Section: The Accepted Gold Standardmentioning

confidence: 99%

“…5-HT 3 -receptor antagonists have become the agents of choice in preventing acute CINV following both moderately and highly emetogenic chemotherapy [11,51]. Complete response and total control rates seen with specific drugs range from 60%-80% for moderately emetogenic chemotherapy [4,[52][53][54], 40%-60% for cisplatin-containing therapy [4,33,55,56], and 25%-60% for high-dose cisplatin regimens [33,35,47,57,58].…”

Section: Optimizing Efficacymentioning

confidence: 99%

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Chemotherapy-Induced Nausea and Vomiting: The Importance of Acute Antiemetic Control

Schnell¹

2003

The Oncologist

189

167

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Nausea and vomiting are two of the most feared side effects of cancer chemotherapy and radiotherapy. Chemotherapy-induced nausea and vomiting can be broadly categorized as acute (occurring within 24 hours of therapy), delayed (persisting for 6-7 days after therapy), or anticipatory (occurring prior to chemotherapy administration). Breakthrough and refractory nausea and vomiting describe the symptoms of uncontrolled emesis. Evidence suggests that good control of nausea and vomiting during the acute period correlates with the control of delayed emesis. Conversely, protection failure during the first 24 hours has a high predictive value for delayed emesis in the same cycle.The 5-HT 3 -receptor antagonists, regarded as the 'gold standard' in antiemetic therapy, are the first-line treatment for moderately and highly emetogenic chemotherapy and radiotherapy regimens in adults and children. Evidence suggests that the 5-HT 3 -receptor antagonists administered in combination with corticosteroids afford the best protection from symptoms of acute emesis and, by extrapolation, the most effective prevention of delayed emesis.Antiemetic therapeutic guidelines stress that the goal of therapy is to prevent cytostatic-induced nausea and vomiting. Therefore, the prophylactic use of the most effective antiemetic regimen-taking into consideration the emetogenicity of the chemotherapy and individual patient characteristics-must be adhered to in order to prevent acute, delayed, and anticipatory nausea and vomiting.

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Section: The Accepted Gold Standardmentioning

confidence: 99%

Section: Optimizing Efficacymentioning

confidence: 99%

Chemotherapy-Induced Nausea and Vomiting: The Importance of Acute Antiemetic Control

Schnell¹

2003

The Oncologist

189

167

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“…59 In addition, comparative studies have demonstrated that, like dolasetron, even the approved dose of tropisetron (5 mg IV or orally) may be suboptimal in patients who are receiving highly emetogenic chemotherapy. 58,60,61 For example, significantly fewer patients who were treated with tropisetron 5 mg IV achieved a complete response (no nausea or emesis or only mild nausea) plus a major response (1 emesis episode or no emesis with moderate-to-severe nausea) after high-dose cisplatin chemotherapy compared with patients who received ondansetron 24 mg IV (P ϭ 0.021). 60 Therefore, a reduction in the dose of tropisetron below 5 mg IV also may be detrimental to patients in terms of emesis control and the effect on their quality of life.…”

Section: Tropisetronmentioning

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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“…In general, these studies demonstrated that shortening the dosing interval or increasing the number of doses did not improve efficacy. A continuous-infusion schedule following an 8-mg intravenous bolus was also found to be effective [42]. However, as demonstrated in the subsequent studies of Beck and Seynaeve, multipledose administration did not improve outcomes [4,53].…”

Section: Schedule Of Administration Of 5-ht 3 Antagonist Antiemeticsmentioning

confidence: 92%

“…Further, all agree that an agent that lessens or prevents emesis following cisplatin will at least be as effective with other chemotherapeutic agents of similar or lesser emetic potential. Randomized studies have demonstrated the effectiveness of 5-HT 3 receptor antagonists for the prevention of acute emesis following cisplatin [7,9,19,42,53,55]. Furthermore, the addition of dexamethasone consistently improved efficacy compared to a 5-HT 3 receptor antagonist alone, establishing this combination as a standard for patients receiving cisplatin-based therapy [25,49].…”

Section: Dose Of 5-ht 3 Receptor Antagonistsmentioning

confidence: 99%

Consensus recommendations for the prevention of vomiting and nausea following high-emetic-risk chemotherapy

Kris

Tonato²,

Bria³

et al. 2010

Support Care Cancer

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In this update of our 2005 document, we used an evidence-based approach whenever possible to formulate recommendations, emphasizing the results of controlled trials concerning the best use of antiemetic agents for the prevention of emesis and nausea following anticancer chemotherapies of high emetic risk. A three-drug combination of a 5-hydroxytryptamine type 3 receptor (5-HT 3 ) receptor antagonist, dexamethasone, and aprepitant beginning before chemotherapy and continuing for up to 4 days remains the standard of care. We address issues of dose, schedule, and route of administration of five selective 5-HT 3 receptor antagonists. We conclude that, for each of these five drugs, there is a plateau in therapeutic efficacy above which further dose escalation does not improve outcome. In trials designed to prove the equivalence of palonosetron to ondansetron and granisetron, palonosetron proved superior in emesis prevention, while adverse effects were comparable. Furthermore, for all classes of antiemetic agents, a single dose is as effective as multiple doses or a continuous infusion. The oral route is as efficacious as the intravenous route of administration.

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Is Navoban® (tropisetron) as effective as Zofran® (ondansetron) in cisplatin-induced emesis?

Cited by 32 publications

References 1 publication

Chemotherapy-Induced Nausea and Vomiting: The Importance of Acute Antiemetic Control

Chemotherapy-Induced Nausea and Vomiting: The Importance of Acute Antiemetic Control

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

Consensus recommendations for the prevention of vomiting and nausea following high-emetic-risk chemotherapy

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