title: The efficacy of triplet antiemetic therapy with 0.75 mg of palonosetron for chemotherapy-induced nausea and vomiting in lung cancer patients receiving highly emetogenic chemotherapy.
abstract: BACKGROUND
  Chemotherapy-induced nausea and vomiting (CINV) are some of the most problematic symptoms for cancer patients. Triplet therapy consisting of a 5HT3 receptor antagonist, aprepitant, and dexamethasone is a guideline-recommended antiemetic prophylaxis for highly emetogenic chemotherapy (HEC). The efficacy and safety of triplet therapy using a 0.75-mg dose of palonosetron have not yet been investigated. We performed a prospective phase II study using triplet antiemetic therapy with 0.75 mg of palonosetron.
  
  
  METHODS
  Chemotherapy-naïve lung cancer patients scheduled to receive HEC were enrolled. The eligible patients were pretreated with antiemetic therapy consisting of the intravenous administration of 0.75 mg of palonosetron, and 9.9 mg of dexamethasone and the oral administration of 125 mg of aprepitant on day 1, followed by the oral administration of 80 mg of aprepitant on days 2-3 and the oral administration of 8 mg of dexamethasone on days 2-4. The primary endpoint was the complete response rate (the CR rate; no vomiting and no rescue medication) during the overall phase (0-120 h).
  
  
  RESULTS
  The efficacy analysis was performed in 63 patients. The CR rates during the overall, acute and delayed phases were 81.0, 96.8, and 81.0%, respectively. The no nausea and no significant nausea rate during the overall phase were 54.0 and 66.7%, respectively. The most common adverse event was grade 1 or 2 constipation.
  
  
  CONCLUSIONS
  Triplet antiemetic therapy using a 0.75-mg dose of palonosetron shows a promising antiemetic effect in preventing CINV in lung cancer patients receiving HEC.
authors: Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata, Japan.
authors: Satoru
authors: S
authors: Miura
authors: Satoshi
authors: S
authors: Watanabe
authors: Kazuhiro
authors: K
authors: Sato
authors: Masato
authors: M
authors: Makino
authors: Osamu
authors: O
authors: Kobayashi
authors: Hiromi
authors: H
authors: Miyao
authors: Akira
authors: A
authors: Iwashima
authors: Masaaki
authors: M
authors: Okajima
authors: Junta
authors: J
authors: Tanaka
authors: Hiroshi
authors: H
authors: Tanaka
authors: Hiroshi
authors: H
authors: Kagamu
authors: Akira
authors: A
authors: Yokoyama
authors: Ichiei
authors: I
authors: Narita
authors: Hirohisa
authors: H
authors: Yoshizawa
mesh_terms: D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000008:administration & dosage / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D000077608:Aprepitant; D002945:Cisplatin / Q000009:adverse effects*; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007546:Isoquinolines / Q000008:administration & dosage* / Q000009:adverse effects; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage* / Q000009:adverse effects; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy* / Q000517:prevention & control; D000077924:Palonosetron; D011446:Prospective Studies; D011812:Quinuclidines / Q000008:administration & dosage* / Q000009:adverse effects; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D012702:Serotonin Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D007546:Isoquinolines; D009025:Morpholines; D011812:Quinuclidines; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists; D000077608:Aprepitant; D000077924:Palonosetron; D003907:Dexamethasone; D002945:Cisplatin
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