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Management of platinum-based chemotherapy-induced acute nausea and vomiting: is there a superior serotonin receptor antagonist?Arthur G. James Comprehensive Cancer Center, The Ohio State University Columbus, OH, US, mehdi.hamadani{at}gmail.com
Arthur G. James Comprehensive Cancer Center, The Ohio State University Columbus, OH, US
Arthur G. James Comprehensive Cancer Center, The Ohio State University Columbus, OH, US
Arthur G. James Comprehensive Cancer Center, The Ohio State University Columbus, OH, US
Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, US, Section of Hematology-Oncology, University of Oklahoma Health Sciences Center and OU Cancer Center, Oklahoma City, OK, US
Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, US, Section of Hematology-Oncology, University of Oklahoma Health Sciences Center and OU Cancer Center, Oklahoma City, OK, US
Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, US, Section of Hematology-Oncology, University of Oklahoma Health Sciences Center and OU Cancer Center, Oklahoma City, OK, US Objective. The last decade has witnessed the great impact of 5-hydroxytryptamine-3 receptor (5-HT3) antagonists in revolutionizing the management of platinum-based chemotherapy–induced acute nausea and vomiting (CINV). However, despite the availability of a variety of 5-HT3 antagonists, little data is published to support superiority of one drug over another, leaving the choice of serotonin receptor antagonist largely empirical. The National Comprehensive Cancer Network and American Society of Clinical Oncology guidelines for management of chemotherapy-associated nausea and vomiting clearly endorse the use of serotonin receptor antagonist; however, no single agent is preferred over the rest.
Methods. Data for patients (n
Results. A total of 126 patients received 369 cycles of platinum-based therapy. Dolasetron (n Conclusion. No significant difference exists in the antiemetic efficacy of the three 5-HT3 antagonists studied in controlling CINV when administered in combination with dexamethasone. Choice of antiemetic regimen should therefore be based on drug cost.
Key Words: acute emesis • chemotherapy-induced acute nausea and vomiting, dolasetron • granisetron • ondansetron
Journal of Oncology Pharmacy Practice, Vol. 13, No. 2,
69-75 (2007) |
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159) receiving platinum-based chemotherapy regimens were retrospectively collected. Patients getting 5-HT3 antagonists without steroids or those with known history of brain metastasis, gastroparesis, and intestinal obstruction were not eligible for the study. Patient characteristics including age, gender, primary diagnosis, history of heavy alcohol intake, chemotherapy regimen administered, number of cycles, and Eastern Cooperative Oncology Group performance status at the start of therapy were noted. Primary outcome was the complete control of platinum-induced acute nausea and vomiting. Secondary outcome measures included control of >grade 1 nausea or vomiting, comparison of two doses of dexamethasone, and antiemetic efficacy among various platinum drugs. National Cancer Institute Common Toxicity Criteria version 2.0 was used to assess toxicity.