title: Efficacy and safety of different doses of granisetron for the prophylaxis of cisplatin-induced emesis.
abstract: The purpose of this study was to evaluate the efficacy and safety of four different doses of granisetron when administered as a single intravenous (i.v.) dose for prophylaxis of cisplatin-induced emesis in a multicenter, randomized, parallel-group, double-blind investigation. A total of 353 chemotherapy-naive patients were enrolled, stratified according to cisplatin dose (moderate dose: 50-80 mg/m2, n = 169; high dose: 81-120 mg/m2, n = 184) and randomized to one of four granisetron doses: 5, 10, 20, or 40 micrograms/kg. Control of emesis was evaluated by the percentages of patients attaining complete response (no vomiting or retching, and no rescue medication) and major response (< or = 2 episodes of vomiting or retching, and no rescue medication). Patients were assessed on an inpatient basis for 18-24 h. Safety analyses consisted of adverse events and laboratory parameter changes. Complete response rates over 24 h after chemotherapy were 23%, 48%, 48%, and 44% for granisetron doses of 5, 10, 20, and 40 micrograms/kg, respectively, in the combined patient population (P = 0.011 for linear trend); 29%, 56%, 58%, and 41%, respectively, in the moderate-dose cisplatin stratum (P = 0.278 for linear trend); and 18%, 41%, 40%, and 47%, respectively, in the high-dose cisplatin stratum (P = 0.011 for linear trend). Transient headache was the most frequently reported adverse event (19%). There was no evidence of association between increased dose and headache. A single 10-, 20- or 40-micrograms/kg dose of granisetron is comparably effective in controlling nausea and vomiting associated with moderate or high-dose cisplatin chemotherapy. Granisetron was safe and well tolerated at all doses.
authors.affiliation: Mayo Clinic Jacksonville, FL 32224, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Perez
authors.forename: R M
authors.initials: RM
authors.lastname: Navari
authors.forename: H G
authors.initials: HG
authors.lastname: Kaplan
authors.forename: R J
authors.initials: RJ
authors.lastname: Gralla
authors.forename: S M
authors.initials: SM
authors.lastname: Grunberg
authors.forename: R H
authors.initials: RH
authors.lastname: Palmer
authors.forename: D
authors.initials: D
authors.lastname: Fitts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001066:Appetite / Q000187:drug effects; D002945:Cisplatin / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D017829:Granisetron / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control; D009369:Neoplasms / Q000188:drug therapy; D012074:Remission Induction; D012449:Safety; D013997:Time Factors; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D002945:Cisplatin; D017829:Granisetron