Ramosetron versus Palonosetron in Combination with Aprepitant and Dexamethasone for the Control of Highly-Emetogenic Chemotherapy-Induced Nausea and Vomiting

Abstract

Original ArticlePurpose The purpose of this study was to compare ramosetron (RAM), aprepitant (APR), and dexamethasone (DEX) [RAD] with palonosetron (PAL), APR, and DEX [PAD] in controlling highlyemetogenic chemotherapy (HEC)-induced nausea and vomiting. Materials and MethodsPatients were randomly assigned (1:1) to receive RAD or PAD:RAM (0.3 mg intravenously) or PAL (0.25 mg intravenously) D1, combined with APR (125 mg orally, D1 and 80 mg orally, D2-3) and DEX (12 mg orally or intravenously, D1 and 8 mg orally, D2-4). Patients were stratified by gender, cisplatin-based chemotherapy, and administration schedule. The primary endpoint was overall complete response (CR), defined as no emesis and no rescue regimen during 5 days of HEC. Secondary endpoints were overall complete protection (CP; CR+nausea score < 25 mm) and total control (TC; CR+nausea score < 5 mm). Quality of life was assessed by Functional Living Index Emesis (FLIE) questionnaire on D0 and D6. ResultsA total of 279 patients receiving RAD (n=137) or PAD (n=142) were evaluated. Overall CR rates in RAD and PAD recipients were 81.8% and 79.6% (risk difference [RD], 2.2%; 95% confidence interval [CI], −7.1 to 11.4), respectively. Overall CP and TC rates for RAD and PAD were 56.2% and 58.5% (RD, −2.3%; 95% CI, −13.9 to 9.4) and 47.5% vs. 43.7% (RD, 3.8%; 95% CI, −7.9 to 15.5), respectively. FLIE total score ≥ 108 (no impact on daily life) was comparable between RAD and PAD (73.9% vs. 73.4%, respectively). Adverse events were similar between the two groups. ConclusionIn all aspects of efficacy, safety and quality of life, RAD is non-inferior to PAD for the control of chemotherapy-induced nausea and vomiting in cancer patients receiving HEC.

Comparison of the Effectiveness of Palonosetron and Ramosetron in Preventing Postoperative Nausea and Vomiting: Updated Systematic Review and Meta-Analysis with Trial Sequential Analysis

“…The full text of the 25 remaining articles was reviewed in further detail, and eight more articles were excluded for the following reasons: systematic review and meta-analysis, [ 8 , 19 , 20 ] no outcome of interest [ 21 ], performed for chemotherapy-induced nausea and vomiting [ 22 , 23 , 24 ], and not a RCT [ 25 ]. The kappa value for selecting articles between the two investigators was 0.930.…”

Effect of Acupuncture on Delayed Emesis for the Patients Who Received High-Emetogenic Chemotherapy with Standard Antiemetic Prophylaxis (KHMC-HO-01): An Open-Label, Randomized Study

“…In our study, ramosetron was used instead of palonosetron [ 31 ]. However, in a recent prospective randomized clinical trial that compared ramosetron and palonosetron in patients receiving HEC in Korea, it was found that ramosetron was not inferior to palonosetron in both efficacy and safety and the quality of life [ 32 ]. Therefore, our study results will be meaningfully applied to the current daily practice.…”

Farmacoterapia atual das náuseas e vômitos induzidos por antineoplásicos

“…Ramosetrona, em combinação com aprepitanto e dexametasona, se mostrou tanto eficaz quanto seguro quando comparado com a palonosetrona em combinação com aprepitanto e dexametasona (Kang et al, 2020) Estudos de fase 2 para o fosaprepitanto e de fase 3 para o rolapitanto demonstram um controle melhorado de NVIQ nas fases tardia e geral quando estes fármacos são adicionados a um regime padrão de antagonista de receptor 5-HT3 (Kumagai et al, 2018;Rojas & Slusher, 2015). A esse regime também foi adicionado a dexametasona, demonstrando eficácia, segurança e tolerabilidade dessa tríade (Ahmed et al, 2018;Schwartzberg et al, 2015).…”