Antiemetic activity of megestrol acetate in patients receiving chemotherapy
Several trials had independently noted that patients receiving megestrol acetate had less nausea and vomiting, but this antiemetic activity of megestrol acetate has not been reported separately in the literature. Our objective was to evaluate the antiemetic ability of megestrol acetate in patients receiving chemotherapy.
Patients and Methods
Patients receiving chemotherapy were randomly assigned to receive either megestrol acetate 320 mg PO or placebo before the first day of chemotherapy, followed on days 1–4 by megestrol acetate 320 mg PO combined with granisetron 3 mg IV and metoclopramide 20 mg IM or only granisetron 3 mg IV combined with metoclopramide 20 mg IM in a crossover manner during two consecutive cycles. Rates of complete protection against both vomiting and moderate-to-severe nausea was the primary end point.
One hundred patients were enrolled in the study. The antiemetic regimen containing megestrol acetate was superior in providing complete protection from nausea and vomiting (45% megestrol acetate regimen vs.17% no megestrol acetate regimen). Complete response of acute phase in both antiemetic regimens was different (85% megestrol acetate regimen vs. 72% no megestrol acetate regimen). Complete response of delayed emesis was also different (49% megestrol acetate regimen vs. 18% no megestrol acetate regimen). Adverse events were mostly mild to moderate. There were no serious drug-related adverse events between the two antiemetic regimens.
Megestrol acetate was shown to be an effective antiemetic agent. Megestrol acetate might be a new antiemetic option for chemotherapy.
KeywordsEmesis Megestrol acetate Granisetron Metoclopramide
This work would not have been possible without the dedication of the cancer center data manager of West China Hospital, the nursing stuff and, above all, the patients who filled in their questionnaires and sent them for evaluation.
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