A meta-analysis comparing the efficacy of four 5-HT3-receptor antagonists for acute chemotherapy-induced emesis

K. Jordan, A. Hinke, A. Grothey, W. Voigt, D. Arnold, H. H. Wolf, H. J. Schmoll

Research output: Contribution to journalReview article

72 Scopus citations

Abstract

Goals of work: Comparing antiemetic efficacy of different 5-HT 3-receptor antagonists (5-HT3RAs) is difficult due to inter-study variability. Therefore, a meta-analysis was performed to comparatively evaluate dolasetron, granisetron, ondansetron and tropisetron for acute chemotherapy-induced nausea and vomiting (CINV). Patients and methods: Comparisons between 5-HT3RAs were based on 44 randomized studies (including 12,343 patients) identified by MEDLINE, CANCERLIT or EMBASE searches and subcategorized by chemotherapy type (cisplatin- or non-cisplatin-based). Main results: When all studies were combined, granisetron was equivalent to ondansetron (n = 27), and showed an advantage vs tropisetron (p = 0.018; n = 12). Ondansetron vs tropisetron (n = 11) and ondansetron vs dolasetron (n = 3) revealed equivalence in each comparison. An advantage for 3 mg granisetron vs 8 mg ondansetron was found in non-cisplatin-based studies (p = 0.015; n = 6). Overall equivalence was seen between ondansetron, 24 or 32 mg, and granisetron, 2 or 3 mg, for all studies (n = 13). There was a possible advantage for higher (24 or 32 mg) vs lower (8 mg) ondansetron dose regimens with cisplatin-based trials (n = 6). No differences were seen between 3 and 1 mg granisetron doses (n = 6). Conclusions: Efficacy of 5-HT3RAs for preventing CINV following cisplatin- and non-cisplatin-based chemotherapy is comparable, with the exception of granisetron vs tropisetron. Some differences were noted in dosing subanalyses.

Original languageEnglish (US)
Pages (from-to)1023-1033
Number of pages11
JournalSupportive Care in Cancer
Volume15
Issue number9
DOIs
StatePublished - Sep 1 2007

Keywords

  • 5-HTRAs
  • Antiemetic
  • Chemotherapy
  • Dosing regimens
  • Efficacy

ASJC Scopus subject areas

  • Oncology

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    Jordan, K., Hinke, A., Grothey, A., Voigt, W., Arnold, D., Wolf, H. H., & Schmoll, H. J. (2007). A meta-analysis comparing the efficacy of four 5-HT3-receptor antagonists for acute chemotherapy-induced emesis. Supportive Care in Cancer, 15(9), 1023-1033. https://doi.org/10.1007/s00520-006-0186-7