1204 Preventing nausea and vomiting during days 2–7 following high dose cisplatin chemotherapy (HDCP)

Is delayed chemotherapy-induced emesis well managed in oncological clinical practice?

“…Ondanestron + dexamethasone provided better protection against delayed emesis than did regimens containing metoclopramide (29% vs 9%), as demonstrated by a randomised trial conducted by The Italian Group for Antiemetic Research [10]. In a study by the National Cancer Institute [2], the combination of dexamethasone + granisetron was shown to be equivalent to dexamethasone alone in antiemesis; either way, clinical trials have established the effectiveness of dexamethasone and its combination with a selective antagonist 5-HT3 or metoclopramide, which are accepted as the preferred treatments for delayed emesis after the administration of cisplatin-containing regimens.…”

Improved prevention of moderately emetogenic chemotherapy‐induced nausea and vomiting with palonosetron, a pharmacologically novel 5‐HT3 receptor antagonist

“…Therefore, according to current evidence-based guidelines (American Society of Clinical Oncology, Multinational Association of Supportive Care in Cancer) and consensus guidelines (American Society of Health-System Pharmacists, National Comprehensive Cancer Network), these 5-HT 3 receptor antagonists are considered therapeutically equivalent and interchangeable when used at equipotent doses. [3][4][5][6][7] Although 5-HT 3 receptor antagonists are part of the current standard of care for patients receiving chemotherapy, a substantial proportion of patients today continue to experience both acute and particularly delayed CINV after moderately or highly emetogenic chemotherapy. 7,8 Therefore, there is still a need to develop new agents to improve control rates and patient care.…”

“…[3][4][5][6][7] Although 5-HT 3 receptor antagonists are part of the current standard of care for patients receiving chemotherapy, a substantial proportion of patients today continue to experience both acute and particularly delayed CINV after moderately or highly emetogenic chemotherapy. 7,8 Therefore, there is still a need to develop new agents to improve control rates and patient care. Although other neurotransmitter pathways besides serotonin are clearly involved in CINV (e.g., substance P and the neurokinin-1 receptor mechanisms), 9 one question has not been fully explored: will major pharmacologic improvements in a novel 5-HT 3 receptor antagonist lead to improved clinical outcomes in patients receiving emetogenic chemotherapy compared with a currently available 5-HT 3 receptor antagonist?…”