Abstract
Purpose
Patients with gastrointestinal cancer who were receiving moderately emetogenic chemotherapy (MEC) were switched from granisetron, a first-generation 5-hydroxytryptamine-3 receptor antagonist, to palonosetron at our hospital. In the present study, we compared effectiveness before and after switching antiemetic treatment.
Methods
Among patients who were receiving MEC for gastrointestinal cancer, we prospectively observed 46 patients given granisetron and 46 given palonosetron. To allow adverse reactions to be graded in accordance with the Common Terminology Criteria for Adverse Events, version 4.0, a questionnaire designed at our hospital was used to compare the occurrence of delayed nausea and vomiting between patients who received granisetron (GRA group) and those who received palonosetron (PAL group).
Results
The incidence of delayed nausea was significantly lower in the PAL group (8.7 %, 4/46; p < 0.01) than in the GRA group (37 %, 17/46). Delayed vomiting developed in five patients (10.9 %) in the GRA group, but did not occur in the PAL group. On the basis of the results of multivariate analysis, young age, female gender, and the use of granisetron were significant risk factors for delayed nausea.
Conclusion
Our survey showed that palonosetron effectively controls delayed nausea caused by MEC for gastrointestinal cancer.


References
Goedhals L, Heron JF, Kleisbauer JP et al (1998) Control of delayed nausea and vomiting with granisetron plus dexamethasone or dexamethasone alone in patients receiving highly emetogenic chemotherapy: a double-blind, placebo-controlled, comparative study. Ann Oncol 9:661–666
Latreille J, Pater J, Johnston D et al (1998) Use of dexamethasone and granisetron in the control of delayed emesis for patients who receive highly emetogenic chemotherapy. National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 16:1174–1178
The Italian Group for Antiemetic Research (2000) Dexamethasone alone or in combination with ondansetron for prevention of delayed nausea and vomiting induced by chemotherapy. N Engl J Med 342:1554–1559
Geling O, Eichler HG (2005) Should 5-hydroxytryptamine-3 receptor antagonists be administered beyond 24 h after chemotherapy to prevent delayed emesis? Systematic re-evaluation of clinical evidence and drug cost implications. J Clin Oncol 23:1289–1294
Wong EH, Clark R, Leung E et al (1995) The interaction of RS25259-197, a potent and antagonist, with 5-HT3 receptors, in vitro. Br J Pharmacol 114:851–859
Maemondo M, Masuda N, Sekine I et al (2009) A phase II study of palonosetron combined with dexamethasone to prevent nausea and vomiting induced by highly emetogenic chemotherapy. Ann Oncol 20:1860–1866
Rojas C, Stathis M, Thomas AG et al (2008) Palonosetron exhibits unique molecular interactions with the 5-HT3 receptor. Anesth Analg 107:469–478
Rojas C, Thomas AG, Alt J et al (2010) Palonosetron triggers 5-HT(3) receptor internalization and causes prolonged inhibition of receptor function. Eur J Pharmacol 626:193–199
Saito M, Aogi K, Sekine I et al (2009) Palonosetron plus dexamethasone versus granisetoron plus dexamethasone for prevention of nausea and vomiting during chemotherapy: a double-blind double-dummy randomised comparative phase III trial. Lancet Oncol 10:115–124
Horie Y, Boku N (2012) A guideline for antimetics use for patients with malignancies. Gan To Kagaku Ryoho 39:1163–1168, Article in Japanese
Molassiotis A, Coventry PA, Stricker CT, Clements C, Eaby B, Velders L, Rittenberg C, Gralla RJ (2007) Validation and psychometric properties of a short clinical scale to measure chemotherapy-induced nausea and vomiting: the MASCC Antiemesis Tool (MAT). J Pain Symptom Manag 34:148–159
Botrel TE, Clark OA, Clark L et al (2011) Efficacy of palonosetron compared to other serotonin inhibitors in preventing chemotherapy-induced nausea and vomiting in patients receiving moderately or highly emetogenic treatment: systematic review and meta-analysis. Support Care Cancer 19:823–832
Roila F, Herrstedt J, Apro M et al (2010) Guideline update for MASCC and ESMO in the prevention of chemotherapy and radiotherapy induced nausea and vomiting; results of the Perugia consensus conference. Ann Oncol 21(Suppl 5):232–243
Basch E, Prestrud AA, Hesketh PJ et al (2011) Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 26:4189–4198
National Comprehensive Cancer Network: NCCN Clinical Practice Guideline in Oncology TM; Antiemesis Ver.1.2012
Sepulveda-Vidosola AC, Betanzos-Cabrera Y, Lastiri GG et al (2008) Palonosetron hydrochloride is an effective and safe option to prevent chemotherapy-induced nausea and vomiting in children. Arch Med Res 39:601–606
Aapro MS, Grunberg SM, Manikhas GM 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 17:1441–1449
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: results of a phase III, single-dose trial versus dolasetron. Cancer 98:2473–2482
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 double-blind randomized phase III trial comparing single-dose of palonosetron with ondansetron. Ann Oncol 14:1570–1577
Yu Z, Liu W, Wang L et al (2008) The efficacy and safety of palonosetron compared with granisetron in preventing highly emetogenic chemotherapy-induced vomiting in the Chinese cancer patients: a phase II, randomized, double-blind parallel, comparative clinical trial. Support Care Cancer 17:99–102
Navari RM (2003) Pathogenesis-based treatment of chemotherapy-induced nausea and vomiting—two new agents. J Support Oncol 1:89–103
Sekine I, Segawa Y, Kubota K et al (2013) Risk factors of chemotherapy-induced nausea and vomiting: index for personalized antiemetic prophylaxis. Cancer Sci 104:711–717
Conflict of interest
We certify that we have no conflict of interest relevant to this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Murakami, M., Hashimoto, H., Yamaguchi, K. et al. Effectiveness of palonosetron for preventing delayed chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy in patients with gastrointestinal cancer. Support Care Cancer 22, 905–909 (2014). https://doi.org/10.1007/s00520-013-2046-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-013-2046-6