Current issues in the management of nausea and vomiting

Gralla, Richard J.

doi:10.1093/annonc/4.suppl_3.s3

Cited by 27 publications

(13 citation statements)

References 16 publications

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“…We noted that the proportion of patients that had experienced nausea and vomiting during previous cycles of chemotherapy was lower in the 1.8-mg/kg group than in the other three groups. Since this is a factor known to predispose to an unsatisfactory response to antiemetic therapy during subsequent cycles of treatment [28], we hypothesized that this could have influenced our results. However, of the eight patients who had a complete response in the 1.8-mg/kg group, six (75%) had previously experienced chemotherapy-related nausea and vomiting.…”

Section: Discussionmentioning

confidence: 99%

Open-label comparison of the antiemetic efficacy of single intravenous doses of dolasetron mesylate in pediatric cancer patients receiving moderately to highly emetogenic chemotherapy

Coppes

Lau

Ingram

et al. 1999

Med. Pediatr. Oncol.

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Background Nausea and vomiting are among the most unpleasant adverse side effects of cancer therapy. Procedure An open‐label dose‐escalation study was conducted to assess the appropriate intravenous dose of dolasetron for pediatric patients undergoing chemotherapy. Patients received dolasetron in single intravenous doses of 0.6 (n = 10), 1.2 (n = 12), 1.8 (n = 12), or 2.4 (n = 12) mg/kg 30 min before receiving emetogenic chemotherapy. Pharmacokinetic parameters were evaluated at each dose level and efficacy was evaluated over the first 24 hr following the administration of dolasetron. Results A complete response was achieved in 10% of patients given 0.6 mg/kg, 25% of patients given 1.2 mg/kg, 67% of patients given 1.8 mg/kg, and 33% of patients given 2.4 mg/kg. Peak plasma concentrations (Cmax) were observed between 0.33 and 0.75 hr following dolasetron infusion. Cmax and area under plasma concentration‐time (AUC) increased with larger doses of dolasetron, while terminal disposition half‐life (t1/2) and apparent clearance (Clapp) were not significantly changed with respect to dose. For 1.8‐mg/kg dolasetron, the t1/2 was 4.98 hr and the maximum plasma concentration (tmax) 0.47 hr. Adverse events were mild to moderate. No serious events occurred. Conclusions. This study suggests that a single intravenous dose of 1.8 mg/kg is the optimum single intravenous dose for controlling chemotherapy‐induced emesis in pediatric patients. Med. Pediatr. Oncol. 33:99–105, 1999. © 1999 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Open-label comparison of the antiemetic efficacy of single intravenous doses of dolasetron mesylate in pediatric cancer patients receiving moderately to highly emetogenic chemotherapy

Coppes

Lau

Ingram

et al. 1999

Med. Pediatr. Oncol.

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“…᭧ 1997 American Cancer Society. 3 ) receptor antagonist, doseresponse trial, doxorubicin, cyclophosphamide, emesis, nausea, antiemetic. R daily-regimen.…”

Section: Discussionmentioning

confidence: 99%

Randomized, double blind, dose‐response trial across four oral doses of dolasetron for the prevention of acute emesis after moderately emetogenic chemotherapy

Rubenstein¹,

Gralla²,

Hainsworth³

et al. 1997

Cancer

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“…Patients were evaluated for their response to anti‐emetic therapy, according to Gralla's scale, as follows: 0: no episodes of vomiting; 1: 1–2 episodes; 2: 3–5 episodes; 3: >5 episodes (Gralla 1993). Nausea was evaluated as follows: 0: no nausea; 1: transient, of a duration of <24 h; 2: continuous or periodic, of a duration of ≥24 h, and requiring bed rest intermittently; 3: requiring bed rest for at least 1 day.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of tropisetron in patients with advanced non-small-cell lung cancer receiving adjuvant chemotherapy with carboplatin and taxanes

et al. 2008

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Even though significant progress has been made, chemotherapy-induced emesis remains a challenging problem. Few studies focus on emesis in patients treated with carboplatin and the observation period is limited to the initial 24 h following chemotherapy. Thus, we investigated if tropisetron (T) monotherapy can adequately prevent acute and delayed emesis in non-small-cell lung cancer (NSCLC) patients receiving a moderately emetogenic chemotherapy (MEC) (carboplatin-containing) regimen. Furthermore, we explored the merits of adding dexamethasone (D) or alprazolam (A) to T, especially in the setting of a pre-existing high level of stress. We studied 60 patients with advanced NSCLC receiving carboplatin and taxanes in three consecutive cycles. During the first cycle, patients received 5 mg of T intravenously before chemotherapy and the same dose per os on each of the following 3 days. In the second cycle, T was co-administered with 8 mg of D once a day, while, during the third cycle, T was combined with per os A 0.25 mg every 12 h and continued over the following 3 days. Finally, we evaluated the impact of stress on the anti-emetic response achieved with the previously described regimens. The combination of T + A was superior to T monotherapy and the combination of T + D, regarding the prevention of acute and delayed emesis. Both T + A and T + D combinations led to appetite improvement, while patients receiving T + A experienced sedation more frequently. Interestingly, subgroup analysis revealed that patients without underlying stress obtained no further benefit by the addition of A or D, while both T + A and T + D combinations led to a better anti-emetic response in patients with stress. In conclusion, T monotherapy provides a satisfactory result in controlling nausea and emesis caused by a MEC regimen in patients without stress. However, the addition of D and, mainly, A improves its anti-emetic effect in patients with obvious stress.

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Current issues in the management of nausea and vomiting

Cited by 27 publications

References 16 publications

Open-label comparison of the antiemetic efficacy of single intravenous doses of dolasetron mesylate in pediatric cancer patients receiving moderately to highly emetogenic chemotherapy

Open-label comparison of the antiemetic efficacy of single intravenous doses of dolasetron mesylate in pediatric cancer patients receiving moderately to highly emetogenic chemotherapy

Randomized, double blind, dose‐response trial across four oral doses of dolasetron for the prevention of acute emesis after moderately emetogenic chemotherapy

Efficacy of tropisetron in patients with advanced non-small-cell lung cancer receiving adjuvant chemotherapy with carboplatin and taxanes

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