Efficacy of triplet regimen antiemetic therapy for chemotherapy‐induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single‐shot palonosetron and consecutive‐day granisetron for CINV in a randomized, single‐blinded crossover study

Abstract

The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV.

Comparative investigation of the anti-emetic effects of granisetron and palonosetron during the treatment of acute myeloid leukemia

“…The results revealed that the anti-emetic effects of granisetron last only a relatively short time when the drug is administered once or even twice per day; however, the effects of palonosetron persist over its long plasma elimination half-life, which facilitates continuous supportive therapy of a daily regimen following nausea. Furthermore, comparing the relative costs in the treatment of bone and soft tissue tumors, Kimura et al (20) demonstrated that a single dose of palonosetron was in no way inferior to continuous administration of multiple doses of granisetron. In the current analysis, palonosetron is also more cost-effective and is not inferior to granisetron when used in continuous administration regimens.…”

Prevention of cisplatin-based chemotherapy-induced delayed nausea and vomiting using triple antiemetic regimens: a mixed treatment comparison

“…Previous studies have shown that patients with osteosarcoma or soft tissue sarcoma do not respond to NK-1 + 5-HT3 + DXM regimens, suggesting the efficacies of triple regimens for preventing CINV may be related to the cancer type [ 45 , 46 ]. We could not perform subgroup analysis of specific cancer types because data on cancer types were lacking in the included studies.…”

Efficacy analysis of the aprepitant-combined antiemetic prophylaxis for non-round cell soft-tissue sarcoma patients received adriamycin and ifosfamide therapy

“…[11,12] In the previous study of chemotherapies including adriamycin plus cisplatin, ifosfamide plus etoposide, and AI for bone and soft-tissue sarcoma, effectiveness of the triplet therapy was examined, and AI was administered in 11 courses out of a total of 96 courses of chemotherapy. [26] Complete response rates of the prophylaxis in an acute, a delayed, and an overall period were 23%, 17%, and 7%, respectively, but specified antiemetic effect of the triplet therapy for AI has not been clarified. In the present study, we also observed that 85% of patients suffered nausea; even prophylaxis by a doublet therapy consisting of 3 mg of granisetron and 8 to 16 mg of DEX (the doublet group) was performed.…”