Open AccessA Systematic Review and Meta‐Analysis of Intravenous Palonosetron in the Prevention of Chemotherapy‐Induced Nausea and Vomiting in Adults
Author(s) -
Likun Zhou,
Xiang Jing,
Yi Ba,
Xin Duan,
Tao Zheng Liu
Publication year - 2011
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2010-0198
Subject(s) - palonosetron , medicine , chemotherapy induced nausea and vomiting , nausea , vomiting , meta analysis , adverse effect , randomized controlled trial , oncology , anesthesia , antiemetic
Objectives. We performed a systematic review and meta‐analysis to compare treatment effectiveness and adverse effects in cancer patients receiving chemotherapy with palonosetron to prevent chemotherapy‐induced nausea and vomiting (CINV). Methods. We identified randomized controlled clinical trials (RCT) comparing palonosetron with first‐generation 5‐HT3RA in the prevention of CINV in cancer patients. Meta‐analyses were performed on homogeneous studies. Fixed or random‐effects models were used to combine data. Results. Eight eligible trials were identified, reporting outcomes on 3,592 patients. Meta‐analyses showed statistically significant differences in favor of palonosetron compared with first‐generation 5‐HT3RA in prevention of acute CINV ( p = .0003), delayed CINV ( p < .00001), and overall phase of CINV ( p < .00001). Subgroup analyses showed statistically significant differences in favor of both 0.25 mg and 0.75 mg of palonosetron in prevention of all phases of CINV. There were no statistically significant differences between 0.25 and 0.75 mg of palonosetron. Compared with the first‐generation 5‐HT3RA, 0.75 mg of palonosetron showed a statistically significant difference in the occurrence of constipation ( p = .04). Interpretation. The use of palonosetron should be considered an integral part of adjuvant therapy for prevention of the acute, delayed, and overall phases of CINV. The 0.25 mg intravenous palonosetron dose is as effective as the 0.75 mg intravenous palonosetron dose. However, 0.75 mg intravenous palonosetron causes constipation more frequently than the first‐generation 5‐HT3RA.