Granisetron, tropisetron, and ondansetron in the prevention of acute emesis induced by a combination of cisplatin-Adriamycin and by high-dose ifosfamide delivered in multiple-day continuous infusions.
The antiemetic efficacy of granisetron, ondansetron and tropisetron was evaluated in patients treated with cisplatin-Adriamycin (CDP/ADM) and ifosfamide (IFO) by continuous infusion (CI). In all, 90 patients with osteosarcoma were randomly assigned to receive granisetron (2 mg/m2), or ondansetron (5.3 mg/m2), or tropisetron (3.3 mg/m2) plus dexamethasone 8 mg/m2. Chemotherapy consisted of CDP (120 mg/m2, 48-h CI) followed by ADM (75 mg/m2, 24-h CI) and then, in the second cycle, delivered 3 weeks later, IFO 15 g/m2 (120-h CI). Complete protection (CP) from emesis was obtained on 59% of the 717 days of treatment, without significant differences among the three study drugs. A significantly higher rate of CP was obtained during chemotherapy with IFO than with CDP/ ADM (69% vs 44%; P<0.0001). The rate of CP declined from the first to the last day of treatment for both CDP/ADM (61% to 27%, P<0.0001) and IFO (95% to 43%) cycles (P<0.0001). When CDP/ ADM and IFO are delivered on multiple days by CI, granisetron, ondansetron and tropisetron have the same antiemetic efficacy, which declines from the first day onward through successive days.
Forni
C
C
Department of Chemotherapy, Istituto Ortopedico Rizzoli, Bologna, Italy. chemioterapia@ior.it
Ferrari
S
S
Loro
L
L
Mazzei
T
T
Beghelli
C
C
Biolchini
A
A
Simoni
P
P
Tremosini
M
M
Strazzari
S
S
Puggioli
C
C
Bacci
G
G
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005121:Extremities; D005260:Female; D017829:Granisetron / Q000627:therapeutic use; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007211:Indoles / Q000627:therapeutic use; D008297:Male; D017294:Ondansetron / Q000627:therapeutic use; D012516:Osteosarcoma / Q000188:drug therapy*; D000077526:Tropisetron; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
D000932:Antiemetics; D002945:Cisplatin; D004317:Doxorubicin; D017829:Granisetron; D007069:Ifosfamide; D007211:Indoles; D017294:Ondansetron; D000077526:Tropisetron