Anti-emetic control with ondansetron in the chemotherapy of breast cancer: a review.
Nausea and vomiting are significant problems in patients receiving outpatient chemotherapy for breast cancer. Three, randomised, double-blind studies comparing the efficacy and safety of ondansetron with placebo in patients receiving 14-day CMF (Study 1), and with metoclopramide in patients receiving FAC/FEC (Study 2) or EC (Study 3) are reviewed. Ondansetron was superior to placebo in Study 1; complete control of emesis (0 emetic episodes) over 15 days was achieved in 62% of ondansetron-treated patients compared to 34% of placebo-treated patients (P = 0.02). Ondansetron was also superior to metoclopramide in Study 2, with complete control of emesis in 66% of patients given ondansetron and 27% on metoclopramide. Complete plus major control of emesis (0-2 emetic episodes) also significantly favoured ondansetron (86% vs 42%; P less than 0.001). In Study 3, complete control of emesis was obtained in 60% of patients given ondansetron and 47% given metoclopramide, complete plus major control being obtained in 72% and 61% for the respective treatments. The difference, however, was not statistically significant (P = 0.230). In Study 2, which was of a crossover design, significantly more patients expressed a preference for ondansetron (63% vs 26%; P = 0.001). Ondansetron was safe and well tolerated.
Marschner
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Universitätsklinikum, Göttingen, Germany.
D000932:Antiemetics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008787:Metoclopramide / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control; D017294:Ondansetron; D011788:Quality of Life; D012702:Serotonin Antagonists; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
D000932:Antiemetics; D007093:Imidazoles; D012702:Serotonin Antagonists; D017294:Ondansetron; D008787:Metoclopramide