title: Control of chemotherapy-induced diarrhea with the synthetic enkephalin BW942C: a randomized trial with placebo in patients receiving cisplatin.
abstract: Diarrhea commonly occurs following the administration of cisplatin. BW942C, a pentapeptide, is a synthetic enkephalin shown to control castor oil-induced and traveler's diarrhea. To assess the safety and efficacy of BW942C in controlling diarrhea caused by cisplatin, 30 adults with lung cancer who had already experienced diarrhea (three or more loose bowel movements) during the 24-hour period following a prior cisplatin administration were randomized to receive either BW942C or placebo during the next cisplatin course. All patients received a concomitant antiemetic regimen including metoclopramide, dexamethasone, and lorazepam during all courses. Patients administered BW942C experienced less diarrhea (27% v 67%, P = .02). Twenty-seven percent of patients given the pentapeptide had loose bowel movements as opposed to 93% who received placebo (P = .0002). There were no significant differences in the incidence and degree of vomiting and other treatment-related side effects observed between the placebo and treatment groups. We conclude that oral BW942C is more effective than placebo in controlling diarrhea following cisplatin chemotherapy.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
authors.forename: M G
authors.initials: MG
authors.lastname: Kris
authors.forename: R J
authors.initials: RJ
authors.lastname: Gralla
authors.forename: R A
authors.initials: RA
authors.lastname: Clark
authors.forename: L B
authors.initials: LB
authors.lastname: Tyson
authors.forename: S
authors.initials: S
authors.lastname: Groshen
mesh_terms: D000328:Adult; D000930:Antidiarrheals / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003967:Diarrhea / Q000139:chemically induced / Q000517:prevention & control*; D004311:Double-Blind Method; D004744:Enkephalin, Methionine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004745:Enkephalins; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D010919:Placebos; D011897:Random Allocation
chemical_list: D000930:Antidiarrheals; D004745:Enkephalins; D010919:Placebos; D004744:Enkephalin, Methionine; C045617:BW 942C; D002945:Cisplatin