Palonosetron versus granisetron in combination with aprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients with gynecologic cancer.
10.3802/jgo.2015.26.4.311
- Author:
Satoe FUJIWARA
1
;
Yoshito TERAI
;
Satoshi TSUNETOH
;
Hiroshi SASAKI
;
Masanori KANEMURA
;
Masahide OHMICHI
Author Information
1. Department of Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan. y-terai@poh.osaka-med.ac.jp
- Publication Type:Comparative Study ; Original Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Antiemetics;
Aprepitant;
Granisetron;
Neoplasms;
Palonosetron;
Serotonin 5-HT3 Receptor Antagonist
- MeSH:
Adult;
Aged;
Antiemetics/*administration & dosage;
Antineoplastic Combined Chemotherapy Protocols/adverse effects;
Carboplatin/administration & dosage/adverse effects;
Cross-Over Studies;
Diet;
Drug Administration Schedule;
Female;
Genital Neoplasms, Female/*drug therapy;
Granisetron/administration & dosage;
Humans;
Isoquinolines/administration & dosage;
Middle Aged;
Morpholines/administration & dosage;
Nausea/chemically induced/*prevention & control;
Paclitaxel/administration & dosage/adverse effects;
Quinuclidines/administration & dosage;
Serotonin 5-HT3 Receptor Antagonists;
Vomiting/chemically induced/*prevention & control
- From:Journal of Gynecologic Oncology
2015;26(4):311-319
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: There is no research regarding the appropriate antiemetic agents for female patients, especially those receiving moderately emetogenic chemotherapy (MEC). We evaluated the antiemetic efficacy of a combination of 5-HT3 receptor with/without aprepitant in patients with gynecological cancer treated with the TC (paclitaxel and carboplatin) regimen of MEC. METHODS: We enrolled 38 patients diagnosed with gynecologic cancer and scheduled to receive the TC regimen. The patients were randomly assigned to receive a 5-HT3 receptor antagonist, either palonosetron in the first cycle followed by granisetron in the second cycle or vice versa. In the third cycle, all patients received a combination of the 5-HT3 receptor and dexamethasone with/without aprepitant. RESULTS: When three drugs were administered, palonosetron consistently produced an equivalent complete response (CR) rate to granisetron in the acute phase (89.5% vs. 86.8%, p=0.87) and delayed phase (60.5% vs. 65.8%, p=0.79). With regard to the change in dietary intake, palonosetron exhibited similar efficacy to granisetron in the acute phase (92.1% vs. 89.4%, p=0.19) and delayed phase (65.7% vs. 68.4%, p=0.14). However, in the delayed phase, the addition of aprepitant therapy with a 5-HT3 receptor antagonist and dexamethasone produced a higher CR rate than a 5-HT3 receptor antagonist with dexamethasone (93.3% vs. 47.8%, p<0.001) and allowed the patients to maintain a higher level of dietary intake (93.3% vs. 56.5%, p<0.001). CONCLUSION: The addition of aprepitant therapy was more effective than the control therapy of a 5-HT3 receptor antagonist, and dexamethasone in gynecological cancer patients treated with the TC regimen.
