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Efficacy of tropisetron in patients with advanced non‐small‐cell lung cancer receiving adjuvant chemotherapy with carboplatin and taxanes
Author(s) -
TSAVARIS N.,
KOSMAS C.,
KOPTERIDES P.,
VADIAKA M.,
KOSMAS N.,
SKOPELITIS H.,
KARADIMA D.,
KOLLIOKOSTA G.,
TZIMA E.,
LOUKERIS D.,
PAGOUNI E.,
BATZIOU E.,
XYLA V.,
KOUFOS C.
Publication year - 2008
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/j.1365-2354.2007.00829.x
Subject(s) - medicine , carboplatin , tropisetron , chemotherapy , regimen , lung cancer , dexamethasone , oncology , chemotherapy regimen , anesthesia , cisplatin , receptor , antagonist
Even though significant progress has been made, chemotherapy‐induced emesis remains a challenging problem. Few studies focus on emesis in patients treated with carboplatin and the observation period is limited to the initial 24 h following chemotherapy. Thus, we investigated if tropisetron (T) monotherapy can adequately prevent acute and delayed emesis in non‐small‐cell lung cancer (NSCLC) patients receiving a moderately emetogenic chemotherapy (MEC) (carboplatin‐containing) regimen. Furthermore, we explored the merits of adding dexamethasone (D) or alprazolam (A) to T, especially in the setting of a pre‐existing high level of stress. We studied 60 patients with advanced NSCLC receiving carboplatin and taxanes in three consecutive cycles. During the first cycle, patients received 5 mg of T intravenously before chemotherapy and the same dose per os on each of the following 3 days. In the second cycle, T was co‐administered with 8 mg of D once a day, while, during the third cycle, T was combined with per os A 0.25 mg every 12 h and continued over the following 3 days. Finally, we evaluated the impact of stress on the anti‐emetic response achieved with the previously described regimens. The combination of T + A was superior to T monotherapy and the combination of T + D, regarding the prevention of acute and delayed emesis. Both T + A and T + D combinations led to appetite improvement, while patients receiving T + A experienced sedation more frequently. Interestingly, subgroup analysis revealed that patients without underlying stress obtained no further benefit by the addition of A or D, while both T + A and T + D combinations led to a better anti‐emetic response in patients with stress. In conclusion, T monotherapy provides a satisfactory result in controlling nausea and emesis caused by a MEC regimen in patients without stress. However, the addition of D and, mainly, A improves its anti‐emetic effect in patients with obvious stress.