Open AccessEfficacy of triplet regimen antiemetic therapy for chemotherapy‐induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single‐shot palonosetron and consecutive‐day granisetron for CINV in a randomized, single‐blinded crossover study
Author(s) -
Kimura Hiroaki,
Yamamoto Norio,
Shirai Toshiharu,
Nishida Hideji,
Hayashi Katsuhiro,
Tanzawa Yoshikazu,
Takeuchi Akihiko,
Igarashi Kentaro,
Inatani Hiroyuki,
Shimozaki Shingo,
Kato Takashi,
Aoki Yu,
Higuchi Takashi,
Tsuchiya Hiroyuki
Publication year - 2015
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.373
Subject(s) - palonosetron , granisetron , medicine , antiemetic , regimen , nausea , chemotherapy induced nausea and vomiting , aprepitant , vomiting , chemotherapy , anesthesia , oncology
The first aim of this study was to evaluate combination antiemetic therapy consisting of 5‐ HT 3 receptor antagonists, neurokinin‐1 receptor antagonists ( NK ‐1RAs), and dexamethasone for multiple high emetogenic risk ( HER ) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single‐shot palonosetron and consecutive‐day granisetron in a randomized, single‐blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK ‐1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single‐shot palonosetron and consecutive‐day granisetron. Antiemetic therapy with a 3‐drug combination was not sufficient to control chemotherapy‐induced nausea and vomiting ( CINV ) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive‐day granisetron was not inferior to single‐shot palonosetron for treating CINV .