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Supportive Care in Cancer

, Volume 13, Issue 2, pp 97–103 | Cite as

Acute emesis: moderately emetogenic chemotherapy

  • Jørn HerrstedtEmail author
  • Jim M. Koeller
  • Fausto Roila
  • Paul J. Hesketh
  • David Warr
  • Cynthia Rittenberg
  • Mario Dicato
Review Article

Abstract

This paper is a review of the recommendations for the prophylaxis of acute emesis induced by moderately emetogenic chemotherapy as concluded at the Perugia Consensus Conference, which took place at the end of March 2004. The review focuses on new studies appearing since the last consensus conference in 1997. The following issues are addressed: dose and schedule of antiemetics, different groups of antiemetics such as corticosteroids, serotonin (5-HT3)-receptor antagonists, dopamine D2 receptor antagonists, and neurokinin (NK1) receptor antagonists. Antiemetic prophylaxis in patients receiving multiple cycles of moderately emetogenic chemotherapy is also reviewed. Consensus statements are given, including optimal dose and schedule of 5-HT3-receptor antagonists and of dexamethasone. The new 5-HT3-receptor antagonist, palonosetron, is a reasonable alternative to the well-established agents of this class—ondansetron, granisetron, tropisetron and dolasetron. It is concluded that the best prophylaxis in patients receiving moderately emetogenic chemotherapy is still the combination of one of the 5-HT3-receptor antagonists and dexamethasone. The results of studies adding a NK1-receptor antagonist to this combination are awaited and might change future recommendations.

Keywords

Serotonin antagonists Dexamethasone Anthracycline Cyclophosphamide Chemotherapy 

References

  1. 1.
    Adams M, Soukop M, Barley V, et al (1995) Tropisetron alone or in combination with dexamethasone for the prevention and treatment of emesis induced by non-cisplatin chemotherapy: a randomized trial. Anticancer Drugs 6:514–521PubMedGoogle Scholar
  2. 2.
    Antiemetic Subcommittee of the Multinational Association of Supportive Care in Cancer (MASCC) (1998) Prevention of chemotherapy- and radiotherapy-induced emesis: results of the Perugia Consensus Conference. Ann Oncol 9:811–819CrossRefPubMedGoogle Scholar
  3. 3.
    ASHP Commission on Therapeutics (1999) ASHP therapeutic guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery. Am J Health Syst Pharm 56:729–764PubMedGoogle Scholar
  4. 4.
    Beck TM, York M, Chang A, et al (1997) Oral ondansetron 8 mg twice daily is as effective as 8 mg three times daily in the prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy. S3A-376 Study Group. Cancer Invest 15:297–303PubMedGoogle Scholar
  5. 5.
    Du Bois A, McKenna CJ, Andersson H, Lahousen M, Kitchener H, Pinter T, Capstick V, Wilkinson JR (1997) A randomised, double-blind, parallel-group study to compare the efficacy and safety of ondansetron (GR38032F) plus dexamethasone with metoclopramide plus dexamethasone in the prophylaxis of nausea and emesis induced by carboplatin chemotherapy. Oncology 54:7–14Google Scholar
  6. 6.
    Davidson NG, Paska W, Van Belle S, Goedhals L, McQuade B, McRae J (1997) Ondansetron suppository: a randomised, double-blind, double-dummy, parallel-group comparison with oral ondansetron for the prevention of cyclophosphamide-induced emesis and nausea. The Ondansetron Suppository Emesis Study Group. Oncology 54:380–386PubMedGoogle Scholar
  7. 7.
    Davidson N, Rapoport B, Erikstein B, et al (1999) Comparison of an orally disintegrating ondansetron tablet with the conventional ondansetron tablet for cyclophosphamide-induced emesis in cancer patients: a multicenter, double-masked study. Ondansetron Orally Disintegrating Tablet Emesis Study Group. Clin Ther 21:492–502CrossRefPubMedGoogle Scholar
  8. 8.
    Eisenberg P, Figueroa-Vadillo J, Zamora R, et al (2003) Improved prevention of moderately emetogenic chemotherapy-induced nausea and vomiting with palonosetron, a pharmacologically novel 5-HT3-receptor antagonist. Cancer 98:2473–2482CrossRefPubMedGoogle Scholar
  9. 9.
    ESMO Guidelines Task Force (2001) ESMO recommendations for prophylaxis of chemotherapy-induced nausea and vomiting. Ann Oncol 12:1059–1060CrossRefPubMedGoogle Scholar
  10. 10.
    Fujii M, Kanke M, Arai Y, et al (2000) A randomized crossover comparison of azasetron alone and azasetron plus dexamethasone for the prevention of nausea and vomiting by chemotherapy including cisplatin. Gan To Kagaku Ryoho 27:1557–1563PubMedGoogle Scholar
  11. 11.
    Goldschmidt H, Salwender H, Egerer G, Kempe R, Voigt T (1997) Comparison of oral itasetron with oral ondansetron: results of a double-blind, active-controlled phase II study in chemotherapy-naive patients receiving moderately emetogenic chemotherapy. Anticancer Drugs 8:436–444PubMedGoogle Scholar
  12. 12.
    Gralla RJ, Osoba D, Kris MG, et al (1999) Recommendations for the use of antiemetics: evidence-based, clinical practice guidelines. J Clin Oncol 17:2971–2994PubMedGoogle Scholar
  13. 13.
    Gralla R, Lichinitser M, Van der Vegt S, 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 14:1570–1577CrossRefPubMedGoogle Scholar
  14. 14.
    Griffin AM, Butow PN, Coates AS, et al (1996) On the receiving end V: patient perceptions and the side effects of cancer chemotherapy in 1993. Ann Oncol 7:189–195PubMedGoogle Scholar
  15. 15.
    Grunberg SM, Deuson RR, Mavros P, et al (2004) Incidence of chemotherapy-induced nausea and vomiting after modern antiemetics. Cancer 100:2261–2268CrossRefPubMedGoogle Scholar
  16. 16.
    Harousseau JL, Zittoun R, Bonneterre J, Hedouin M, Ouvry J (2000) Improvement in the control of chemotherapy induced emesis with ondansetron, methylprednisolone and lorazepam combination in patients treated by a moderate emetic treatment and uncontrolled by a previous antiemetic combination. Bull Cancer 87:491–497PubMedGoogle Scholar
  17. 17.
    Herrstedt J, Sigsgaard T, Boesgaard M, Jens TP, Dombernowsky P (1993) Ondansetron plus metopimazine compared with ondansetron alone in patients receiving moderately emetogenic chemotherapy. N Engl J Med 328:1076–1080CrossRefPubMedGoogle Scholar
  18. 18.
    Hesketh PJ, Grunberg SM, Gralla RJ, Warr DG, Roila F, de Wit R, Chawla SP, Carides AD, Ianus J, Elmer ME, Evans JK, Beck K, Reines S, Horgan KJ; Aprepitant Protocol 052 Study Group (2003) The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin—the Aprepitant Protocol 052 Study Group. J Clin Oncol 21:4112–4119CrossRefPubMedGoogle Scholar
  19. 19.
    Italian Group for Antiemetic Research (1995) Dexamethasone, granisetron, or both for the prevention of nausea and vomiting during chemotherapy for cancer. N Engl J Med 332:1–5CrossRefPubMedGoogle Scholar
  20. 20.
    Italian Group for Antiemetic Research (2004) Randomized, double-blind, dose-finding study of dexamethasone in preventing acute emesis induced by anthracyclines, carboplatin, or cyclophosphamide: J Clin Oncol 22:725–729Google Scholar
  21. 21.
    Jones AL, Hill AS, Soukop M, et al (1991) Comparison of dexamethasone and ondansetron in the prophylaxis of emesis induced by moderately emetogenic chemotherapy. Lancet 338(8765):483–487CrossRefPubMedGoogle Scholar
  22. 22.
    Kaizer L, Warr D, Hoskins P, et al (1994) Effect of schedule and maintenance on the antiemetic efficacy of ondansetron combined with dexamethasone in acute and delayed nausea and emesis in patients receiving moderately emetogenic chemotherapy: a phase III trial by the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 12:1050–1057PubMedGoogle Scholar
  23. 23.
    Kang YK, Park YH, Ryoo BY, et al (2002) Ramosetron for the prevention of cisplatin-induced acute emesis: a prospective randomized comparison with granisetron. J Int Med Res 30:220–229PubMedGoogle Scholar
  24. 24.
    Lofters WS, Pater JL, Zee B, et al (1997) Phase III double-blind comparison of dolasetron mesylate and ondansetron and an evaluation of the additive role of dexamethasone in the prevention of acute and delayed nausea and vomiting due to moderately emetogenic chemotherapy. J Clin Oncol 15:2966–2973PubMedGoogle Scholar
  25. 25.
    Perez EA, Lembersky B, Kaywin P, Kalman L, Yocom K, Friedman C (1998) Comparable safety and antiemetic efficacy of a brief (30-second bolus) intravenous granisetron infusion and a standard (15-minute) intravenous ondansetron infusion in breast cancer patients receiving moderately emetogenic chemotherapy. Cancer J Sci Am 4:52–58PubMedGoogle Scholar
  26. 26.
    Perez EA, Hesketh P, Sandbach J, et al (1998) Comparison of single-dose oral granisetron versus intravenous ondansetron in the prevention of nausea and vomiting induced by moderately emetogenic chemotherapy: a multicenter, double-blind, randomized parallel study. J Clin Oncol 16:754–760PubMedGoogle Scholar
  27. 27.
    Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, Julie Ma G, Eldridge K, Hipple A, Evans JK, Horgan KJ, Lawson F; Aprepitant Protocol 054 Study Group (2003) Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo-controlled trial in Latin America. Cancer 97:3090–3098CrossRefPubMedGoogle Scholar
  28. 28.
    Sigsgaard T, Herrstedt J, Andersen LJ, et al (1999) Granisetron compared with prednisolone plus metopimazine as antiemetic prophylaxis during multiple cycles of moderately emetogenic chemotherapy. Br J Cancer 80:412–418CrossRefPubMedGoogle Scholar
  29. 29.
    Sigsgaard T, Herrstedt J, Handberg J, Kjaer M, Dombernowsky P (2001) Ondansetron plus metopimazine compared with ondansetron plus metopimazine plus prednisolone as antiemetic prophylaxis in patients receiving multiple cycles of moderately emetogenic chemotherapy. J Clin Oncol 19:2091–2097PubMedGoogle Scholar
  30. 30.
    Soukop M, McQuade B, Hunter E, et al (1992) Ondansetron compared with metoclopramide in the control of emesis and quality of life during repeated chemotherapy for breast cancer. Oncology 49:295–304PubMedGoogle Scholar
  31. 31.
    Warr D, Willan A, Fine S, et al (1991) Superiority of granisetron to dexamethasone plus prochlorperazine in the prevention of chemotherapy-induced emesis. J Natl Cancer Inst 1169–1173Google Scholar
  32. 32.
    de Wit R, Schmith PIM, Verweij J, et al (1996) Analysis of cumulative probabilities shows that the efficacy of 5-HT3 antagonist prophylaxis is not maintained. J Clin Oncol 14:644–651PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Jørn Herrstedt
    • 1
    Email author
  • Jim M. Koeller
    • 2
  • Fausto Roila
    • 3
  • Paul J. Hesketh
    • 4
  • David Warr
    • 5
  • Cynthia Rittenberg
    • 6
  • Mario Dicato
    • 7
  1. 1.Department of Oncology 54 B1Copenhagen University HospitalHerlevDenmark
  2. 2.University of Texas Health Science Center at San AntonioSan AntonioUSA
  3. 3.Policlinico HospitalPerugiaItaly
  4. 4.Caritas St. Elizabeth’s Medical Center of BostonBostonUSA
  5. 5.Princess Margaret HospitalUniversity of TorontoCanada
  6. 6.Rittenberg Oncology ConsultingMetairieUSA
  7. 7.Luxembourg Medical CenterLuxembourg

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