title: Prevention of cisplatin-based chemotherapy-induced delayed nausea and vomiting using triple antiemetic regimens: a mixed treatment comparison.
abstract: A variety of triple antiemetic regimens are being used to prevent cisplatin-based chemotherapy induced delayed emesis and nausea in cancer patients. We performed a network meta-analysis to compare the efficacies of the different regimens. Electronic searches of the PubMed, Cochrane Library and MEDLINE databases were performed to identify randomized controlled trials, and data were analyzed using JAGS, Stata 14.0 and R project. The primary outcome was a complete response (CR). The secondary outcomes were no vomiting (NV) and no nausea (NN). Among the 398 studies identified, 10 were eligible and included, providing data on nine regimens. In the CR analysis, the absolute rank of netupitant + palonosetron + dexamethasone (NEPA) was 0.8579. In the NV and NN analyses, NEPA's absolute ranks were 0.8631 and 0.7902, respectively. The compliance of patients treated with rolapitant + granisetron + dexamethasone (RGD) was the best due to a low incidence of adverse events, and good compliance was also observed with NEPA. It was difficult to achieve good compliance with aprepitant + granisetron + dexamethasone (AGD). Overall, NEPA was the best regimen, and aprepitant + ondansetron + dexamethasone (AOD) is also worthy of recommendation because of its low cost and good effect. For patients with severe constipation, hiccups, asthenia and/or delayed nausea, RGD is worthy of consideration.
authors.affiliation: Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Shi
authors.affiliation: Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Li
authors.affiliation: Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
authors.forename: Hongjia
authors.initials: H
authors.lastname: Li
authors.affiliation: Digestive Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
authors.forename: Qiqi
authors.initials: Q
authors.lastname: Le
authors.affiliation: Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Liu
authors.affiliation: Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
authors.forename: Shaoqi
authors.initials: S
authors.lastname: Zong
authors.affiliation: Oncology Department of Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
authors.forename: Leizhen
authors.initials: L
authors.lastname: Zheng
authors.affiliation: Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
authors.forename: Fenggang
authors.initials: F
authors.lastname: Hou
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000077608:Aprepitant; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017829:Granisetron / Q000627:therapeutic use; D006801:Humans; D007546:Isoquinolines / Q000627:therapeutic use; D009025:Morpholines / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D009369:Neoplasms / Q000188:drug therapy*; D017294:Ondansetron / Q000627:therapeutic use; D000077924:Palonosetron; D011812:Quinuclidines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013141:Spiro Compounds / Q000627:therapeutic use; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D000077608:Aprepitant; D002945:Cisplatin; D003907:Dexamethasone; D017829:Granisetron; D007546:Isoquinolines; D009025:Morpholines; D017294:Ondansetron; D000077924:Palonosetron; D011812:Quinuclidines; D013141:Spiro Compounds; C578834:rolapitant
keywords: chemotherapy-induced nausea and vomiting (CINV); cisplatin-based chemotherapy; highly emetogenic chemotherapy