Palonosetron vs ondansetron: Prevention of chemotherapy-induced nausea and vomiting in pediatric patients in a multicycle study.

Kabíčková, Edita; Wachtel, Antonio; Basharova, E.; Spinelli, Tulla; Pierre, Nicolas; Kovàcs, Gabór

doi:10.1200/jco.2015.33.15_suppl.10077

Cited by 2 publications

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“…A double-blind, randomized, pivotal trial evaluated the efficacy and safety of two different doses of palonosetron compared to ondansetron for the prevention of CINV in pediatric patients aged from full-term neonates to less than 17 years who were scheduled to receive MEC or HEC. 48 Palonosetron was administered as either 10 µg/kg (maximum total dose of 0.75 mg) in the lower dose group or 20 µg/kg (maximum total dose of 1.5 mg) in the higher dose group. All patients randomized to ondansetron received three doses of 0.15 mg/kg (maximum total dose of 32 mg).…”

Section: Efficacy Of Palonosetronmentioning

confidence: 99%

Palonosetron in the prevention of chemotherapy-induced nausea and vomiting: an evidence-based review of safety, efficacy, and place in therapy

Celio¹,

Niger²,

Ricchini³

et al. 2015

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Introduction: The second-generation 5-hydroxytryptamine-3 (5-HT3) receptor antagonist palonosetron is effective in the prevention of chemotherapy-induced nausea and vomiting (CINV) associated with highly and moderately emetogenic chemotherapy (HEC and MEC, respectively). In addition, palonosetron has been the first and, at present, the only 5-HT3 receptor antagonist to have a specific indication for the prevention of delayed CINV associated with MEC. The unique pharmacology of this antagonist is thought to partly explain its improved efficacy against delayed symptoms.Aims: To review the evidence underlying the use of palonosetron in preventing CINV.Evidence review: A recent meta-analysis consistently showed that palonosetron significantly increases the control of both emesis and nausea during the acute and delayed phases after single-day HEC or MEC. Consistent with these findings from trials that did not include an neurokinin-1 (NK-1) receptor antagonist, randomized controlled trials recently showed that a triple combination with palonosetron achieves significantly better control of delayed CINV, particularly delayed nausea, in patients undergoing HEC or the high-risk combination of an anthracycline and cyclophosphamide (AC). Evidence from randomized studies also supports palonosetron as a valuable option to reduce the total corticosteroid dose administered in patients undergoing multiple cycles of MEC or AC chemotherapy. Additional benefits of palonosetron include the lack of a warning on cardiac safety and no known clinically significant drug–drug interactions.Place in therapy and conclusion: Evidence currently available indicates that palonosetron significantly adds to the clinician’s ability to effectively control CINV in patients undergoing HEC or MEC. It is recommended in the international guidelines for the prevention of CINV caused by MEC. The high safety profile and the opportunity to reduce the total corticosteroid dose with no loss in efficacy against delayed CINV should also contribute to a wider use of palonosetron in clinical practice.

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Section: Efficacy Of Palonosetronmentioning

confidence: 99%

Palonosetron in the prevention of chemotherapy-induced nausea and vomiting: an evidence-based review of safety, efficacy, and place in therapy

Celio¹,

Niger²,

Ricchini³

et al. 2015

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Palonosetron compared with ondansetron in pediatric cancer patients: multicycle analysis of a randomized Phase III study

et al. 2017

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aim:To investigate across multiple cycles the efficacy and safety of palonosetron in the prevention of chemotherapy-induced nausea and vomiting in pediatric cancer patients receiving highly or moderately emetogenic chemotherapy (HEC/MEC). Patients & methods: Patients were randomly assigned to 10, 20 μg/kg palonosetron or 3 × 150 μg/kg ondansetron for up to four cycles of HEC/MEC. Results: In all on-study chemotherapy cycles, complete response rates were higher in patients in the 20 μg/kg palonosetron group than the ondansetron group. Treatment-emergent adverse events were comparable between the palonosetron 20 μg/kg and ondansetron groups. conclusion: Over four cycles of HEC/ MEC, 20 μg/kg palonosetron was an efficacious and safe treatment for the prevention of chemotherapy-induced nausea and vomiting in pediatric cancer patients. Chemotherapy-induced nausea and vomiting (CINV) are common and distressing side effects in cancer patients receiving highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC) regimens [1,2]. CINV negatively impacts on patient quality of life [3], and can lead to medical complications and to noncompliance or premature discontinuation of anticancer therapy [4]. It is recognized that children receiving chemotherapy are more prone to vomiting than adults, and it is estimated that 70% of pediatric cancer patients receiving chemotherapy will develop CINV [2].Prevention of CINV in adult cancer patients receiving HEC or MEC regimens can be achieved through the use of antiemetic agents, a combination of a 5-hydroxytryptamine-3 (5-HT 3 ) receptor antagonist, a corticosteroid and a neurokinin-1 (NK 1 ) receptor antagonist is recommended [5][6][7]. While fewer studies of these agents have been performed in pediatric cancer patients than in adults, at the time of the study design, the combination of a 5-HT 3 receptor antagonist with a corticosteroid was recommended for pediatric patients receiving HEC or MEC chemotherapy regimens [2,5,6]. In later guidance from the Pediatric Oncology Group of Ontario (POGO), children scheduled to receive HEC are recommended to receive antiemetic prophylactic therapy of ondansetron or granisetron plus dexamethasone and aprepitant (≥12 years of age and receiving antineoplastic drugs not known to interact with aprepitant) or ondansetron or granisetron plus dexamethasone (<12 years of For reprint orders, please contact: reprints@futuremedicine.com

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Palonosetron vs ondansetron: Prevention of chemotherapy-induced nausea and vomiting in pediatric patients in a multicycle study.

Cited by 2 publications

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Palonosetron in the prevention of chemotherapy-induced nausea and vomiting: an evidence-based review of safety, efficacy, and place in therapy

Palonosetron in the prevention of chemotherapy-induced nausea and vomiting: an evidence-based review of safety, efficacy, and place in therapy

Palonosetron compared with ondansetron in pediatric cancer patients: multicycle analysis of a randomized Phase III study

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