Effectiveness of palonosetron for preventing delayed chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy in patients with gastrointestinal cancer.
OBJECTIVE
Patients with gastrointestinal cancer who were receiving moderately emetogenic chemotherapy (MEC) were switched from granisetron, a first-generation 5-hydroxytryptamine-3 receptor antagonist, to palonosetron at our hospital. In the present study, we compared effectiveness before and after switching antiemetic treatment.


METHODS
Among patients who were receiving MEC for gastrointestinal cancer, we prospectively observed 46 patients given granisetron and 46 given palonosetron. To allow adverse reactions to be graded in accordance with the Common Terminology Criteria for Adverse Events, version 4.0, a questionnaire designed at our hospital was used to compare the occurrence of delayed nausea and vomiting between patients who received granisetron (GRA group) and those who received palonosetron (PAL group).


RESULTS
The incidence of delayed nausea was significantly lower in the PAL group (8.7%, 4/46; p < 0.01) than in the GRA group (37%, 17/46). Delayed vomiting developed in five patients (10.9%) in the GRA group, but did not occur in the PAL group. On the basis of the results of multivariate analysis, young age, female gender, and the use of granisetron were significant risk factors for delayed nausea.


CONCLUSIONS
Our survey showed that palonosetron effectively controls delayed nausea caused by MEC for gastrointestinal cancer.
Department of Pharmacy, Matsuyama Red Cross Hospital, Bunkyo-cho, Matsuyama-shi, Ehime, 790-8524, Japan, michi@matsuyama.jrc.or.jp.
Michiyasu
M
Murakami
Hiroki
H
Hashimoto
Kyohei
K
Yamaguchi
Ikuko
I
Yamaguchi
Shozo
S
Senba
Takeshi
T
Siraishi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D017829:Granisetron / Q000627:therapeutic use; D006801:Humans; D007546:Isoquinolines / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D000077924:Palonosetron; D011446:Prospective Studies; D011812:Quinuclidines / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
D000932:Antiemetics; D000970:Antineoplastic Agents; D017829:Granisetron; D007546:Isoquinolines; D000077924:Palonosetron; D011812:Quinuclidines