title: Comparison between the antiemetic effects of palonosetron and granisetron in breast cancer patients treated with anthracycline-based regimens.
abstract: Chemotherapy-induced nausea and vomiting is a serious adverse side-effect of anthracycline-based chemotherapy regimens, in patients with breast cancer. A combination of three drugs, 5-hydroxytryptamine (5-HT3) receptor antagonist, aprepitant and dexamethasone, is recommended for antiemetic therapy. Palonosetron (PALO), a novel 5-HT3receptor antagonist has been identified to be effective against delayed nausea and vomiting. In this study, the results of PALO for patients who received anthracycline-based chemotherapy were compared with that of granisetron (GRA) using a crossover study design. This study evaluated the efficacy of antiemetics in the first cycle of chemotherapy, as well as the second and third cycles. A total of 21 patients and 19 patients were assigned to PALO and GRA treatment groups during the first cycle of chemotherapy, respectively. The patients switched to the other antiemetic drug for the second chemotherapy cycle (PALO followed by GRA or GRA followed by PALO). The patients could select PALO or GRA antiemetics for the third cycle, according to their preference. A total of 21 patients selected PALO and 18 patients selected GRA in the third cycle, and one patient was withdrawn from the study as their third cycle questionnaire was not obtained. No significant differences between PALO and GRA were identified in first and second cycles. However, during the third cycle, a significant difference was observed in acute-phase complete control of emetic events between the PALO and GRA groups, which was defined as no emetic episode, no additional antiemetic treatment and no more than mild nausea, between PALO and GRA. These results demonstrated that changing antiemetics may affect the efficacy of antiemetics. This study indicates that alteration of antiemetic regimens, including drug combination and order, may improve the efficacy of antiemetic treatment.
authors.affiliation: Department of Breast Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ohzawa
authors.affiliation: Department of Gastrointestinal Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miki
authors.affiliation: Department of Breast Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hozumi
authors.affiliation: Department of Breast Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Chieko
authors.initials: C
authors.lastname: Miyazaki
authors.affiliation: Department of Breast Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sagara
authors.affiliation: Department of Breast Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Breast Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Shiba
authors.affiliation: Department of Breast Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Joutoku
authors.affiliation: Department of Breast Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Sakuragi
authors.affiliation: Department of Breast Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Takehara
authors.affiliation: Department of Gastrointestinal Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Yasunaru
authors.initials: Y
authors.lastname: Sakuma
authors.affiliation: Department of Metabolic Disorder, Diabetes Research Center, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Nishimura
authors.affiliation: Department of Clinical Oncology, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Fujii
authors.affiliation: Department of Gastrointestinal Surgery, Jichi Medical University, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yasuda
keywords: antiemetic therapy; granisetron; palonosetron