Randomized, double-blind trial comparing the antiemetic effect of tropisetron plus metopimazine with tropisetron plus placebo in patients receiving multiple cycles of multiple-day cisplatin-based chemotherapy

Abstract

Tropisetron plus metopimazine is superior to tropisetron during 4 cycles of multiple-day cisplatin-based chemotherapy, but both treatments are ineffective in a number of patients. The effect of the combination seems comparable to that of ondansetron plus dexamethasone. Newer drugs such as the neurokinin(1) receptor antagonist, aprepitant, should be investigated to optimize antiemetic therapy in patients receiving multiple-day chemotherapy.

Multinational study exploring patients’ perceptions of side-effects induced by chemo-radiotherapy

“…However, the guidelines do not take the dose of cisplatin into consideration. The efficacy of a two-drug combination (a serotonin RA and a corticosteroid) in preventing vomiting during the first 24 h after administration of cisplatin 20 mg/m 2 , seems to be in the same order as the efficacy of a three-drug antiemetic regimen (adding NK 1 RA) in patients receiving cisplatin P70 mg/m 2 [16][17][18]. This is why in our study only a minor proportion of the patients received a NK 1 RA as recommended by the guidelines.…”

Efficacy and tolerability of transdermal granisetron for the control of chemotherapy-induced nausea and vomiting associated with moderately and highly emetogenic multi-day chemotherapy: a randomized, double-blind, phase III study

“…Constipation was reported more frequently in the GTDS group than the oral granisetron group; however, all GTDS-treated patients received granisetron for all 7 days of the patch application period, whereas patients received oral granisetron for 3–5 days, depending on the duration of chemotherapy. Constipation was reported less frequently than has been previously observed with intravenous 5-HT 3 RAs [4, 13, 19]. …”

“…Prophylaxis of CINV associated with multi-day chemotherapy is, therefore, a key clinical goal and, although relatively under-represented in the literature [4, 5], an important area of research.…”

Antiemesis

“…75,[114][115][116][117] A specific antiemetic regimen for each day is difficult to recommend, especially because acute and delayed emesis may overlap after the initial day of chemotherapy until the last day of chemotherapy. The period of risk for delayed emesis after the conclusion of chemotherapy also depends on the specific regimen and emetogenic potential of the last chemotherapy agent administered in the regimen.…”