title: Infusion of palonosetron plus dexamethasone for the prevention of chemotherapy-induced nausea and vomiting.
abstract: Serotonin (5-HT3) receptor antagonists are the foundation of standard antiemetic care for cancer patients receiving emetogenic chemotherapy. To enhance the efficacy of these supportive care agents, dexamethasone is routinely admixed with the 5-HT3 receptor antagonist, which is administered by intravenous infusion before chemotherapy begins. This phase II study evaluated the safety and efficacy of intravenous palonosetron admixed with dexamethasone to prevent chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately emetogenic chemotherapy. Cancer patients received palonosetron 0.25 mg plus dexamethasone 8 mg admixed in 50 mL of infusion solution before receiving at least one qualifying chemotherapeutic agent (cyclophosphamide < or = 1,500 mg/m2, doxorubicin > or = 20 mg/m2, carboplatin, or oxaliplatin). Patients used diaries to record nausea and emesis experienced and rescue medications used. Of 32 participants, 27 (84%) had a complete response (no emesis and no rescue medication) during the acute (0-24 hours) interval posttherapy, 19 (59%) had a complete response during the delayed (> 24-120 hours) posttherapeutic interval, and 19 (59%) had a complete response during the overall (0-120 hours) posttreatment interval. A total of 23 patients (72%) had no emetic episodes, 16 (50%) had no nausea, and 21 (66%) used no rescue medication throughout the overall 5-day interval. The combination was well tolerated. Palonosetron plus dexamethasone given as a pretreatment infusion is effective and safe in preventing acute and delayed CINV in patients receiving moderately emetogenic chemotherapy.
authors.affiliation: M. D. Anderson Cancer Center Orlando, 1400 S. Orange Ave., Orlando, Florida 32806, USA. julio.hajdenberg@orhs.org
authors.forename: Julio
authors.initials: J
authors.lastname: Hajdenberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Grote
authors.forename: Lorrin
authors.initials: L
authors.lastname: Yee
authors.forename: Roberto
authors.initials: R
authors.lastname: Arevalo-Araujo
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Latimer
mesh_terms: D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D016190:Carboplatin / Q000009:adverse effects; D003520:Cyclophosphamide / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004317:Doxorubicin / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007546:Isoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D009944:Organoplatinum Compounds / Q000009:adverse effects; D000077150:Oxaliplatin; D000077924:Palonosetron; D011812:Quinuclidines / Q000008:administration & dosage / Q000627:therapeutic use*; D012702:Serotonin Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D007546:Isoquinolines; D009944:Organoplatinum Compounds; D011812:Quinuclidines; D012702:Serotonin Antagonists; D000077150:Oxaliplatin; D000077924:Palonosetron; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D016190:Carboplatin