Palonosetron and dexamethasone for prevention of nausea and vomiting in patients receiving high-dose chemotherapy with auto-SCT

Abstract

The aim of this study was to determine the efficacy of palonosetron combined with dexamethasone in prevention of chemotherapy (CT)-induced nausea and vomiting (CINV) in patients receiving high-dose (HD)-CT with auto-SCT, and the efficacy of a second dose of palonosetron in treating breakthrough emesis. One hundred thirty-four patients treated with HD-CT and auto-SCT for hematologic malignancies received palonosetron as prophylaxis for CINV on the first day of conditioning; patients were also administered dexamethasone throughout the entire period of conditioning. If breakthrough emesis occurred, a second dose of palonosetron was administered at 72 h after the first administration. Complete response and complete protection were observed in 36 and 26% of patients, respectively. One-half of the patients, re-treated with palonosetron for breakthrough emesis, were successfully rescued. Treatment with palonosetron plus dexamethasone seems to be encouraging in terms of prophylaxis of CINV and treatment of breakthrough emesis in the setting of HD-CT.

Antiemetic therapy for multiple-day chemotherapy and additional topics consisting of rescue antiemetics and high-dose chemotherapy with stem cell transplant: review and consensus statement

“…In this trial, dexamethasone was administered throughout the entire treatment period. CR rate was only 36%; however, 50% of the patients were retreated with palonosetron for breakthrough emesis and were successfully rescued [17].…”

Palonosetron to prevent nausea and vomiting in children undergoing BMT: efficacy and safety

“…5 Palonosetron prevented nausea and vomiting in 36% of patients undergoing autologous BMT, whereas in another 26% symptom control was achieved following a second dose. 7 In childhood cancers, the optimal schedule of palonosetron has not been established yet. Kadota et al 8 administered the drug at 3 or 10 mg/kg, and found these dosages equieffective and equitoxic.…”

Evaluation of an Every-Other-Day Palonosetron Schedule to Control Emesis in Multiple-Day High-Dose Chemotherapy

“…Few prospective, small-size trials assessing multiple dosing schedules of palonosetron in the setting of HDC have been published since enrollment into this trial began [13][14][15][16]. Although these studies suggest that palonosetron for multiple days can be more effective against CINV in patients receiving multiple-day HDC, the optimal dosing schedule of palonosetron in this setting remains to be investigated.…”