Cancer Chemotherapy and Pharmacology

, Volume 56, Issue 3, pp 231–238 | Cite as

Is there a pharmacological basis for differences in 5-HT3-receptor antagonist efficacy in refractory patients?

  • Ronald de WitEmail author
  • Matti Aapro
  • Peter R Blower


5-HT3-receptor antagonists are the current antiemetic ‘gold standard’ for chemotherapy- and radiotherapy-induced nausea and vomiting. Interestingly, studies have shown that patients experiencing poor control of acute chemotherapy-induced nausea and vomiting with one antiemetic therapy may respond well to another agent, including a drug of the same class. This review examines pharmacological differences between the 5-HT3-receptor antagonists in order to determine potential reasons for their differing efficacy, particularly in relation to refractory emesis. Differences in drug metabolism by the cytochrome P450 system, inadequate dosing of the respective agents, differences in onset and duration of action, and effects on serotonin release and reuptake are discussed.


5-HT3-receptor antagonists Chemotherapy-induced nausea and vomiting Refractory emesis 



This manuscript was supported by Roche.


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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  1. 1.Rotterdam Cancer InstituteRotterdamThe Netherlands
  2. 2.Clinique de GenolierGenolierSwitzerland
  3. 3.Poole House, Great YeldhamEssexUK

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