Evaluation of the efficacy of palonosetron for prevention of chemotherapy-induced nausea and vomiting in patients with gastric cancer treated with S-1 plus cisplatin.
OBJECTIVE
The purpose of our study was to evaluate the efficacy of a new combination antiemetic therapy consisting of palonosetron, aprepitant, and dexamethasone in gastric cancer patients undergoing chemotherapy with S-1 plus cisplatin.


METHODS
This prospective, multi-institutional observational study assessed patient-reported nausea, vomiting, use of rescue therapy, change of dietary intake, and Functional Living Index-Emesis (FLIE) questionnaire results. The percentages of patients showing complete response (CR; no emesis and non-use of any rescue antiemetics) and complete protection (CP; no significant nausea and non-use of any rescue antiemetics), change of dietary intake, and impact of chemotherapy-induced nausea and vomiting on daily life during the overall (0-120 h after cisplatin administration), acute (0-24 h), and delayed (24-120 h) phases were examined. These findings were compared with our previous study, which used granisetron, aprepitant, and dexamethasone, to assess the relative effectiveness of palonosetron versus granisetron in combination antiemetic therapy.


RESULTS
Of the 72 included patients, 66 (91.6 %), 70 (97.2 %), and 50 (69.1 %) achieved CR, and 48 (66.7 %), 61 (84.7 %) and 49 (68.1 %) achieved CP during in the overall, acute, and delayed phases of cisplatin administration, respectively. Approximately half of the patients had some degree of anorexia. FLIE results indicated that 78.6 % of patients maintained their quality of life. Palonosetron was not superior to granisetron in combination antiemetic therapy.


CONCLUSIONS
Three-drug combination antiemetic therapy with palonosetron, aprepitant, and dexamethasone was tolerable in gastric cancer patients undergoing treatment with S-1 plus cisplatin. The predominance of palonosetron to granisetron was not demonstrated in this study.
Department of Gastroenterological Surgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
Katsunobu
K
Oyama
Department of Gastroenterological Surgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan. fushida@staff.kanazawa-u.ac.jp.
Sachio
S
Fushida
Department of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
Masahide
M
Kaji
Department of Surgery, Public Central Hospital of Matto Ishikawa, Hakusan, Japan.
Toshiya
T
Takeda
Department of Surgery, Takaoka City Hospital, Takaoka, Japan.
Kazuhisa
K
Yabushita
Department of Surgery, Yatsuo General City Hospital, Toyama, Japan.
Hideaki
H
Nezuka
Department of General and Digestive Surgery, Kanazawa Medical University, Uchinada, Japan.
Shinichi
S
Kinami
Department of Surgery, Toyama Rosai Hospital, Uozu, Japan.
Naotaka
N
Kadoya
Department of Gastroenterology, Keiju Medical Center, Nanao, Japan.
Yuki
Y
Takai
Department of Surgery, Toyama City Hospital, Toyama, Japan.
Yuji
Y
Tsukioka
Department of Surgery, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan.
Shigekazu
S
Ohyama
Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Kunihiro
K
Tsuji
Department of Gastroenterological Surgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
Tomoya
T
Tsukada
Department of Gastroenterological Surgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
Jun
J
Kinoshita
Department of Gastroenterological Surgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
Takashi
T
Fujimura
Department of Gastroenterological Surgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
Tetsuo
T
Ohta
D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D000077608:Aprepitant; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000627:therapeutic use; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D017829:Granisetron / Q000627:therapeutic use; D006801:Humans; D007546:Isoquinolines / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects; D000077924:Palonosetron; D011446:Prospective Studies; D011788:Quality of Life; D011812:Quinuclidines / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
D000932:Antiemetics; D000077608:Aprepitant; D002945:Cisplatin; D003907:Dexamethasone; D004338:Drug Combinations; D017829:Granisetron; D007546:Isoquinolines; D009025:Morpholines; D010094:Oxonic Acid; D000077924:Palonosetron; D011812:Quinuclidines; D005641:Tegafur; C079198:S 1 (combination)
Anorexia; CINV; Gastric cancer; Palonosetron; QOL