title: Tropisetron in the prevention of acute nausea and vomiting in patients treated with high dose epirubicin.
abstract: Tropisetron is a novel selective antagonist of the type-3 serotonin (5-HT3) receptor, with proven efficacy in the control of emesis related to cancer treatment. Epirubicin in doses of > 100 mg/m2 has a high emetogenic potential. This study was designed to determine whether a single intravenous administration of tropisetron could prevent acute nausea and vomiting in patients treated with high dose epirubicin. Forty chemotherapy naive breast cancer patients treated with epirubicin at a dose of 110 mg/m2 on an outpatient basis were enrolled in the study. Tropisetron 5 mg i.v. was used as antiemetic prophylaxis. "On demand" treatment with tropisetron 5 mg p.os was used for the rescue of patients who failed on the initial i.v. dose. Complete control of acute nausea and vomiting had 62.5% (95% C.I. 47.2-77.8), partial control 15% (95% C.I. 3.8-26.2) and 22.5% (95% C.I. 9.3-35.7) insufficient control or failure. Headache was the most common adverse event reported in 3 patients (7.5%) and constipation in 2 patients (5%). Interestingly, patients with a negative experience of nausea and vomiting during pregnancy and those treated for metastatic disease, had a better control of chemotherapy-induced nausea and vomiting. In conclusion, a single 5 mg i.v. dose of tropisetron is safe and effective in preventing acute emesis in patients treated with high dose epirubicin.
authors.affiliation: Oncology Section, Ioannina University Hospital, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Nicolaides
authors.forename: T
authors.initials: T
authors.lastname: Giannakakis
authors.forename: D
authors.initials: D
authors.lastname: Skarlos
authors.forename: A
authors.initials: A
authors.lastname: Athanassiadis
authors.forename: G
authors.initials: G
authors.lastname: Fountzilas
authors.forename: D
authors.initials: D
authors.lastname: Damigos
authors.forename: N
authors.initials: N
authors.lastname: Pavlidis
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D000932:Antiemetics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003248:Constipation / Q000139:chemically induced; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007275:Injections, Intravenous; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D016896:Treatment Outcome; D000077526:Tropisetron; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D000903:Antibiotics, Antineoplastic; D000932:Antiemetics; D007211:Indoles; D016179:Granulocyte Colony-Stimulating Factor; D015251:Epirubicin; D000077526:Tropisetron