Methylprednisolone versus Metoclopramide as Antiemetic Treatment in Patients Receiving Adjuvant Cyclophosphamide, Methotrexate, 5-Fluorouracil (CMF) Chemotherapy: A randomized crossover blind study.

Abstract

Nineteen women receiving their first cycle of adjuvant chemotherapy for early breast cancer were randomized between two antiemetic drugs: methylprednisolone (MPN) 125mg and metoclopramide (MCP) 20mg, both given by intravenous push as a single dose. The chemotherapy included: cyclophosphamide, methotrexate and 5-fluorouracil (CMF). The total response rates for MPN and MCP were: complete protection 11% versus 0% and partial protection 63% versus 11% of the patients, respectively (P = 0.007). Eighteen patients (95%) preferred MPN over MCP. Common side effects with both drugs were: drowsiness, headache and diarrhea. MPN is recommended as an antiemetic in patients receiving CMF adjuvant chemotherapy.

Antiemetic activity of corticosteroids in patients receiving cancer chemotherapy: dosing, efficacy, and tolerability analysis

“…MP has been shown to have substantial efficacy as prophylaxis against CINV in patients receiving chemotherapeutic agents with all levels of emetogenicity. In women treated for breast cancer with an initial course of cyclophosphamide, methotrexate, and 5-fluorouracil, prophylaxis with MP was superior to metoclopramide and prevented CINV at least partially for 63% of patients [17]. In a second trial, MP provided complete antiemetic protection in 67% of women [18].…”