Antiemetic effect of palonosetron and first-generation serotonin inhibitors in combination with aprepitant and dexamethasone

Abstract

Background/Aims: Palonosetron has shown to be more effective than serotonin inhibitors, like ondansetron and dolasetron, in preventing chemotherapy-induced nausea and vomiting (CINV) among patients undergo-ing moderately emetogenic chemotherapy (MEC), while being similarly effective as ondansetron among patients undergoing highly emetogenic chemotherapy (HEC). The present study aimed to examine the antiemetic effective-ness of palonosetron and other serotonin inhibitors in combination with aprepitant and dexamethasone for MEC or HEC. Methods: A retrospective analysis was performed with the data from patients who were treated with serotonin inhibitors, aprepitant, and dexamethasone for MEC or HEC between July 2009 and January 2011. Patients in Group A were treated with palonosetron, aprepitant, and dexamethasone. Patients in Group B were treated with first-generation serotonin inhibitors, aprepitant, and dexamethasone. Results: Final data for analysis included 370 patients (i.e., 223 and 117 patients respectively in Groups A and B). The numbers of patients who received MEC and HEC were respectively 110 and 260. No case of grade 3-4 nausea/vomiting was detected. There were no significant differences between the Groups A and B across the acute and delayed CINV phases. The proportions of emesis-free patients during the acute phase (0-24 h) in both groups were similar: 78% and 76% respectively in Groups A and B (P=0.57). The proportions of emesis-free patients during the delayed phase (24-120 h) in both groups were similiar: 67% and 71% respectively (P=0.48). Conclusions: When combined with aprepitant and dexamethasone, all serotonin inhibitors seem to be equally effective for MEC orr HEC.