title: Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study.
abstract: The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, 920-8641, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kimura
authors.forename: Norio
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Shirai
authors.forename: Hideji
authors.initials: H
authors.lastname: Nishida
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hayashi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Tanzawa
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takeuchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Igarashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inatani
authors.forename: Shingo
authors.initials: S
authors.lastname: Shimozaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Kato
authors.forename: Yu
authors.initials: Y
authors.lastname: Aoki
authors.forename: Takashi
authors.initials: T
authors.lastname: Higuchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D000077608:Aprepitant; D001859:Bone Neoplasms / Q000188:drug therapy; D018592:Cross-Over Studies; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D017829:Granisetron / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007546:Isoquinolines / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy*; D064729:Neurokinin-1 Receptor Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000077924:Palonosetron; D011812:Quinuclidines / Q000008:administration & dosage / Q000627:therapeutic use; D012509:Sarcoma / Q000188:drug therapy; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D000077608:Aprepitant; D003907:Dexamethasone; D017829:Granisetron; D007546:Isoquinolines; D009025:Morpholines; D064729:Neurokinin-1 Receptor Antagonists; D000077924:Palonosetron; D011812:Quinuclidines; D058831:Serotonin 5-HT3 Receptor Antagonists
keywords: Antiemetic therapy; bone and soft tissue sarcoma; chemotherapy-induced nausea and vomiting; crossover trial; granisetron; palonosetron