Control of high-dose-cisplatin-induced emesis with an all-oral three- drug antiemetic regimen

Paul J. Hesketh, Angelie Roman, Ann M. Hesketh, Edith A. Perez, Martin Edelman, David R. Gandara

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

In this pilot trial, the antiemetic efficacy and tolerability of an all- oral antiemetic combination in the prevention of both acute and delayed nausea and vomiting following high-dose cisplatin was evaluated. Fifty-two patients receiving cisplatin (median dose 100 mg/m2) were entered. Patients received (1) 60 min prior to cisplatin: prochlorperazine spansule 15 mg, dexamethasone 20 mg, granisetron 2 mg; (2) 12 h after cisplatin: prochlorperazine spansule 15 mg, dexamethasone 10 mg; (3) on days 2 and 3: prochlorperazine spansule 15 mg b.i.d., dexamethasone 8 mg b.i.d.; (4) on days 4 and 5: dexamethasone 4 mg b.i.d. All antiemetics were administered orally. The study period was the 120 h after cisplatin administration. The primary efficacy end-point was complete control (no vomiting, retching or antiemetic rescue) of delayed emesis (24-120 h after cisplatin). Complete control of delayed emesis was achieved in 26 patients (53%). Nineteen patients (39%) noted no delayed nausea. Complete control of acute emesis (24 h after cisplatin) was attained in 44 patients (86%). The no nausea rate during the first 24 h was 74%. Overall, 39 patients (80%) were satisfied or very satisfied with their outcome. Treatment was well tolerated with infrequent and minor adverse events. In conclusion, an all-oral combination of granisetron, dexamethasone and prochlorperazine is a highly effective and well-tolerated regimen for preventing acute cisplatin-induced emesis. Control of delayed emesis was not better than with current standard treatment, and more effective approaches are needed.

Original languageEnglish (US)
Pages (from-to)46-48
Number of pages3
JournalSupportive Care in Cancer
Volume8
Issue number1
DOIs
StatePublished - Jan 2000

Keywords

  • Antiemetics
  • Cisplatin
  • Dexamethasone
  • Emesis
  • Granisetron
  • Prochlorperazine

ASJC Scopus subject areas

  • Oncology

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