Abstract
Purpose
We aimed to investigate the efficacy of 0.25 mg dose of palonosetron and granisetron in triplet antiemetic prophylaxis in breast cancer patients receiving HEC.
Methods
Patients with nonmetastatic breast cancer who received HEC [doxorubicin or epirubicin plus cyclophosphamide (AC/EC)] were enrolled in the study. The prophylactic triplet antiemetic regimens were used according to the doctor’s preference during the first cycle of HEC as intravenous dexamethasone and palonosetron 0.25 mg or granisetron 3 mg on day 1 as well as oral aprepitant (125 mg on day 1 and 80 mg on days 2 and 3).The primary endpoint was complete response rate (CR) on acute and delayed chemotherapy-induced nausea and vomiting (CINV), separately.
Results
A total of 118 female patients were included in the study. Patients received AC (83%), EC (3%), and dose-dense AC (14%) as adjuvant (88%) or neoadjuvant (12%). The majority of patients received palonosetron (59%) containing antiemetic treatment. The CR rate on acute and delayed vomiting was very high and not statistically different in both of the arms (acute 87% vs. 96%, p = 0.089; delayed 90% vs. 92%, p = 0.489), respectively. Nevertheless, the CR rate on either acute or delayed nausea was lower than vomiting (acute 51% vs. 51%; delayed 38% vs. 29%, p = 0.203; respectively).
Conclusions
This is the second study that compared a 0.25 mg dose of palonosetron with first-generation setron in triplet antiemetic prophylaxis in cancer patients receiving HEC. We could not find meaningful statistical differences between two arms, regarding CR rate on acute and delayed CINV.
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References
Longo DL, Navari RM, Aapro M (2016) Antiemetic prophylaxis for chemotherapy-induced nausea and vomiting. N Engl J Med 374(14):1356–1367. https://doi.org/10.1056/NEJMra1515442
Vieira L, Souza FH, Brunetto AT, Sasse AD, Paulo J, Lima N (2012) Neurokinin-1 receptor antagonists for chemotherapy-induced nausea and vomiting: a systematic review. J Natl Cancer Inst 104:1280–1292. https://doi.org/10.1093/jnci/djs335
Jordan K, Hinke A, Grothey A, Voigt W, Arnold D, Wolf H (2007) A meta-analysis comparing the efficacy of four 5-HT3-receptor antagonists for acute chemotherapy-induced emesis. Support Care Cancer 15:1023–1033. https://doi.org/10.1007/s00520-006-0186-7
Lau TKH, Yip CHW, Yeo W (2016) State of the art antiemetic therapy for cancer patients. Curr Oncol Rep 18(1):1–13. https://doi.org/10.1007/s11912-015-0486-5
Navari RM (2014) Palonosetron for the treatment of chemotherapy-induced nausea and vomiting. Expert Opin Pharmacother 15(17):2599–2608
Rojas C, Raje M, Tsukamoto T, Slusher BS (2014) Molecular mechanisms of 5-HT3 and NK1 receptor antagonists in prevention of emesis. Eur J Pharmacol 722(1):26–37. https://doi.org/10.1016/j.ejphar.2013.08.049
Abdel-Rahman O (2016) Neurokinin-1 inhibitors in the prevention of nausea and vomiting from highly emetogenic chemotherapy: a network meta-analysis. Ther Adv Med Oncol 8(5):396–406. https://doi.org/10.1177/1758834016654902
Zhang Y, Yang Y, Zhang Z, Fang W, Kang S, Luo Y et al (2017) Neurokinin-1 receptor antagonist-based triple regimens in preventing chemotherapy-induced nausea and vomiting: a network meta-analysis. J Natl Cancer Inst 109(2):217. https://doi.org/10.1093/jnci/djw217
Wenzell CM, Berger MJ, Blazer MA, Crawford BS, Griffith NL, Wesolowski R et al (2013) Pilot study on the efficacy of an ondansetron-versus palonosetron-containing antiemetic regimen prior to highly emetogenic chemotherapy. Support Care Cancer 21(10):2845–2851. https://doi.org/10.1007/s00520-013-1865-9
Tsuneizumi M, Saito M, Ogata H, Kawai Y, Hoosoya K, Sugisaki K, Katsumata N, Yonemoto NMJ (2016) > Posters. Available from: https://simul-europe.com/2016/mascc/posters. Accessed 23–25 June 2016
Suzuki K, Yamanaka T, Hashimoto H, Shimada Y, Arata K, Matsui R et al (2016) Randomized, double-blind, phase III trial of palonosetron versus granisetron in the triplet regimen for preventing chemotherapy-induced nausea and vomiting after highly emetogenic chemotherapy: TRIPLE study. Ann Oncol 27(8):1601–1606. https://doi.org/10.1093/annonc/mdw220
Saito M, Aogi K, Sekine I, Yoshizawa H, Yanagita Y, Sakai H et al (2009) Palonosetron plus dexamethasone versus granisetron plus dexamethasone for prevention of nausea and vomiting during chemotherapy: a double-blind, double-dummy, randomised, comparative phase III trial. Lancet Oncol 10(2):115–124. https://doi.org/10.1016/S1470-2045(08)70313-9
Kubota K, Saito M, Aogi K, Sekine I, Yoshizawa H, Yanagita Y et al (2016) Control of nausea with palonosetron versus granisetron, both combined with dexamethasone, in patients receiving cisplatin-or anthracycline plus cyclophosphamide-based regimens. Support Care Cancer 24(9):4025–4033. https://doi.org/10.1007/s00520-016-3203-5
Gralla R, Lichinitser M, Van Der Vegt S, Sleeboom H, Mezger J, Peschel C et al (2003) Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with ondansetron. Ann Oncol 14(10):1570–1577
Aapro MS, Grunberg SM, Manikhas GM, Olivares G, Suarez T, Tjulandin SA et al (2006) A phase III, double-blind, randomized trial of palonosetron compared with ondansetron in preventing chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy. Ann Oncol 17(9):1441–1449. https://doi.org/10.1093/annonc/mdl137
Jin Y, Sun W, Gu D, Yang J, Xu Z, Chen J (2013) Comparative efficacy and safety of palonosetron with the first 5-HT3 receptor antagonists for the chemotherapy-induced nausea and vomiting: a meta-analysis. Eur J Cancer Care 22(1):41–50. https://doi.org/10.1111/j.1365-2354.2012.01353.x
Sekine I, Segawa Y, Kubota K, Saeki T (2013) Risk factors of chemotherapy-induced nausea and vomiting: index for personalized antiemetic prophylaxis. Cancer Sci 104(6):711–717. https://doi.org/10.1111/cas.12146
Popovic M, Warr DG, DeAngelis C, Tsao M, Chan KKW, Poon M et al (2014) Efficacy and safety of palonosetron for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV): a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 22(6):1685–1697. https://doi.org/10.1007/s00520-014-2175-6
Schwartzberg L, Barbour SY, Morrow GR, Ballinari G, Thorn MD, Cox D (2014) Pooled analysis of phase III clinical studies of palonosetron versus ondansetron, dolasetron, and granisetron in the prevention of chemotherapy-induced nausea and vomiting (CINV). Support Care Cancer 22(2):469–477. https://doi.org/10.1007/s00520-013-1999-9
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We thank all patients for participating in the study. Any financial resource was not used for this work to be carried out.
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Araz, M., Karaagac, M., Korkmaz, L. et al. Comparison of palonosetron and granisetron in triplet antiemetic therapy in nonmetastatic breast cancer patients receiving high emetogenic chemotherapy: a multicenter, prospective, and observational study. Cancer Chemother Pharmacol 83, 1091–1097 (2019). https://doi.org/10.1007/s00280-019-03831-4
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DOI: https://doi.org/10.1007/s00280-019-03831-4