title: Efficacy of Single-dose First-generation 5-HT3Receptor Antagonist and Dexamethasone for Preventing Nausea and Vomiting Induced by Low-dose Carboplatin-based Chemotherapy.
abstract: Carboplatin (CBDCA) is known to exhibit a high emetic risk among moderate-emetic risk anticancer drugs, and the dose of CBDCA varies in different therapies. In concurrent chemoradiotherapy (CCRT) for non-small cell lung cancer (NSCLC), the weekly administration of CBDCA (area under the curve (AUC) 2 mg/ml/min) and paclitaxel (PTX: 40 mg/m2) is frequently applied as standard therapy. However, the optimal antiemetic measures in the use of such low-dose CBDCA remain unclear. In this study, we retrospectively assessed the antiemetic effect of a single-dose of a first-generation 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) and dexamethasone in the weekly CBDCA+PTX therapy in CCRT.
  
  
  
  The subjects were patients with NSCLC who were administered weekly CBDCA+PTX therapy in CCRT between January 2011 and December 2016 at our Department. As an antiemetic measure, a first-generation 5-HT3RA, azasetron (10 mg, orally) or granisetron (3 mg, intravenously), and dexamethasone (9.9 mg, intravenously) were administered on day 1. The patients were evaluated for the following efficacy end-points for the first cycle: Complete response (CR; defined as no vomiting or retching episodes with no rescue medication) in the acute phase (0-24 hours), delayed phase (>24-120 hours), and overall phase (0-120 hours). Other efficacy endpoints evaluated were no vomiting or retching, and no nausea in all phases.
  
  
  
  The subjects we assessed in this study were 46 patients who were administered weekly CBDCA+PTX therapy in CCRT. For the overall, acute, and delayed phases, the complete response rates were 89.1%, 100%, and 89.1%, respectively. The rate of no nausea in the overall, acute, and delayed phases was 78.3%, 100%, and 78.3%, respectively. The rate of no vomiting in the overall, acute, and delayed phases was 95.7%, 100%, and 95.7%, respectively.
  
  
  
  A single dose of a first-generation 5-HT3RA and dexamethasone had a favorable suppressive effect on nausea and vomiting in weekly CBDCA+PTX therapy for NSCLC.
authors.affiliation: Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan d.kytril@gmail.com.
authors.forename: Daizo
authors.initials: D
authors.lastname: Kaito
authors.affiliation: Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Iihara
authors.affiliation: Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.|Department of Respiratory Medicine, Murakami Memorial Hospital, Asahi University, Gifu, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Funaguchi
authors.affiliation: Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Junki
authors.initials: J
authors.lastname: Endo
authors.affiliation: Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Ito
authors.affiliation: Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Komei
authors.initials: K
authors.lastname: Yanase
authors.affiliation: Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Toyoshi
authors.affiliation: Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sasaki
authors.affiliation: Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
authors.forename: Chiemi
authors.initials: C
authors.lastname: Hirose
authors.affiliation: Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Arai
authors.affiliation: Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Kitahora
authors.affiliation: Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Itoh
authors.affiliation: Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Minatoguchi
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D016190:Carboplatin / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology; D003907:Dexamethasone / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D044406:Receptors, Serotonin, 5-HT3 / Q000737:chemistry; D012189:Retrospective Studies; D018570:Risk Assessment; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000627:therapeutic use*; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy*
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D044406:Receptors, Serotonin, 5-HT3; D058831:Serotonin 5-HT3 Receptor Antagonists; D003907:Dexamethasone; D016190:Carboplatin
keywords: Lung cancer; chemotherapy; low dose carboplatin; nausea; vomiting