Palonosetron (Aloxi) and dexamethasone for the prevention of acute and delayed nausea and vomiting in patients receiving multiple-day chemotherapy.
OBJECTIVE
The objective of this study was to determine the efficacy of palonosetron combined with dexamethasone in prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) in patients receiving multiple-day chemotherapy and the efficacy of a second dose of palonosetron in treating breakthrough emesis.


METHODS
Forty-six patients treated with multiple-day chemotherapy for hematologic malignancies received palonosetron as prophylaxis for CINV on the first day of chemotherapy and dexamethasone throughout the entire period of chemotherapy. If breakthrough emesis occurred, a second dose of palonosetron was administered after 72 h following the first administration. The results were retrospectively compared to group of patients with similar clinical characteristics undergoing similar multiple-day chemotherapy. This group had received single-dose ondansetron as CINV prophylaxis on the first day of chemotherapy plus dexamethasone throughout the entire period of chemotherapy and metoclopramide for breakthrough emesis.


RESULTS
One hundred eighty and 173 chemotherapy cycles were administered in the palonosetron and ondansetron groups, respectively. Nausea and vomiting were absent in 80% of patients of the palonosetron group and 60% of the control group (p < 0.05). In the palonosetron group, 67% of patients who experienced CINV were successfully rescued by a second dose of palonosetron, while in the ondansetron group, only 22% showed a no CINV after metoclopramide treatment (p = 0.04).


CONCLUSIONS
The present results appear to be encouraging in terms of complete prophylaxis of CINV and treatment of breakthrough emesis in the setting of multiple-day chemotherapy.
Oncology Department, Via San Lorenzo Colli 312/d, 90146, Palermo, Italy. mamusso@libero.it
Maurizio
M
Musso
Renato
R
Scalone
Vincenza
V
Bonanno
Alessandra
A
Crescimanno
Vita
V
Polizzi
Ferdinando
F
Porretto
Carlo
C
Bianchini
Tania
T
Perrone
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy; D006801:Humans; D007546:Isoquinolines / Q000009:adverse effects* / Q000627:therapeutic use; D007558:Italy; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D000077924:Palonosetron; D011446:Prospective Studies; D011812:Quinuclidines / Q000009:adverse effects* / Q000627:therapeutic use; D012702:Serotonin Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D055815:Young Adult
D000932:Antiemetics; D018931:Antineoplastic Agents, Hormonal; D007546:Isoquinolines; D011812:Quinuclidines; D012702:Serotonin Antagonists; D000077924:Palonosetron; D003907:Dexamethasone