title: A randomized trial of oral nabilone and prochlorperazine compared to intravenous metoclopramide and dexamethasone in the treatment of nausea and vomiting induced by chemotherapy regimens containing cisplatin or cisplatin analogues.
abstract: Eighty patients receiving their first course of chemotherapy with regimens containing cisplatin or cisplatin analogues entered this open crossover study comparing nabilone 2 mg and prochlorperazine 5 mg given orally every 12 h for four doses against metoclopramide 2 mg/kg loading dose intravenously (i.v.), then 3 mg/kg as an (i.v.) infusion over 8 h and dexamethasone 20 mg (i.v.) over 3-5 min at the time of chemotherapy. There was complete control of nausea and vomiting in 24 patients (32%) given metoclopramide and dexamethasone compared to 14 patients (19%) given nabilone and prochlorperazine. For the 70 patients who completed the crossover assessment of emesis on a linear analogue scale significantly favoured metoclopramide and dexamethasone (P = 0.02). However, there was no overall patient preference for the metoclopramide and dexamethasone combination (nabilone and prochlorperazine 31 vs. metoclopramide and dexamethasone 26; 13 no preference), because a significant proportion of the patients receiving the cisplatin analogue carboplatin preferred nabilone and prochlorperazine (16 vs. 5; 1 no preference; P = 0.013). For patients receiving cisplatin chemotherapy metoclopramide and dexamethasone remains the antiemetic of choice but for regimens containing carboplatin, nabilone and prochlorperazine is better tolerated and preferred by the patients.
authors.affiliation: Department of Medical Oncology, Royal Infirmary, Glasgow, U.K.
authors.forename: D
authors.initials: D
authors.lastname: Cunningham
authors.forename: C J
authors.initials: CJ
authors.lastname: Bradley
authors.forename: G J
authors.initials: GJ
authors.lastname: Forrest
authors.forename: A W
authors.initials: AW
authors.lastname: Hutcheon
authors.forename: L
authors.initials: L
authors.lastname: Adams
authors.forename: M
authors.initials: M
authors.lastname: Sneddon
authors.forename: M
authors.initials: M
authors.lastname: Harding
authors.forename: D J
authors.initials: DJ
authors.lastname: Kerr
authors.forename: M
authors.initials: M
authors.lastname: Soukop
authors.forename: S B
authors.initials: SB
authors.lastname: Kaye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D003907:Dexamethasone / Q000627:therapeutic use; D013759:Dronabinol / Q000031:analogs & derivatives / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control*; D009369:Neoplasms / Q000188:drug therapy; D011346:Prochlorperazine / Q000627:therapeutic use; D011897:Random Allocation; D014839:Vomiting / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; C011941:nabilone; D013759:Dronabinol; D003907:Dexamethasone; D008787:Metoclopramide; D002945:Cisplatin; D011346:Prochlorperazine