New drugs for chemotherapy-induced nausea and vomiting: focus on palonosetron.
Significant progress has been made in the development of effective, convenient and well-tolerated means to prevent chemotherapy-induced nausea and vomiting (CINV). Nevertheless, a substantial minority of patients continue to have suboptimal antiemetic control, and additional treatment approaches are needed. One avenue of investigation being pursued involves the evaluation of a new 5-hydroxytryptamine (5-HT(3)) receptor antagonist (palonosetron) that differs from available serotonin antagonists in its markedly longer half-life (40 h) and greater binding affinity for the type-3 serotonin receptor. Analysis of available clinical data demonstrates that palonosetron is an active and well-tolerated new 5-HT(3) antagonist. Moreover, single-dose palonosetron, prior to chemotherapy, has demonstrated improved control of CINV through the full period of emetic risk with a single dose. Palonosetron is recommended as the preferred treatment of acute and delayed emesis prevention with moderate emetic risk chemotherapy in the most recently published evidence-based antiemesis consensus guidelines. Further studies incorporating dexamethasone to 5-HT(3) antagonists will be necessary to determine the relative efficacy of palonosetron compared with available agents. These trials could open a new era in the treatment of CINV.
Tonini
Giuseppe
G
University Campus Bio-Medico, Medical Oncology, Via E. Longoni 69, 00155, Rome, Italy. g.tonini@unicampus.it
Vincenzi
Bruno
B
Santini
Daniele
D
D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015507:Drugs, Investigational / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D007546:Isoquinolines / Q000737:chemistry / Q000627:therapeutic use*; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy*; D000077924:Palonosetron; D011812:Quinuclidines / Q000737:chemistry / Q000627:therapeutic use*; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy*
D000970:Antineoplastic Agents; D015507:Drugs, Investigational; D007546:Isoquinolines; D011812:Quinuclidines; D000077924:Palonosetron