Reduction of carboplatin induced emesis by ondansetron

Abstract

al., 1988;Hesketh et al., 1989;Einhorn et al., 1990). In randomised studies it has been proven superior to both placebo (Cubeddu et al., 1990) and high dose metoclopramide (Marty et al., 1990) in controlling cisplatin induced emesis. In non-cisplatin containing chemotherapy regimens it has been shown superior to metoclopramide in four randomised studies (Schmoll, 1989;Kaasa et al., 1990).Vomiting after most chemotherapeutic agents tends to start within a couple of hours of treatment. The onset of vomiting after carboplatin, however, is often delayed for 6-1O h (Calvert et al., 1982) and there is no previous study of the effect of ondansetron on carboplatin induced vomiting. This paper reports our initial experience with ondansetron in patients treated with carboplatin, who had proven refractory to a previous aggressive antiemetic regimen. Patients and methods PatientsAdult patients receiving carboplatin chemotherapy were eligible for treatment with ondansetron if they had vomited three times or more in the first 24 h of the previous course of chemotherapy. However, patients were excluded if they had a severe concurrent illness other than neoplasia, had hepatic dysfunction other than due to metastases or were receiving any other antiemetic medication, including benzodiazepines.Twenty-three women with ovarian cancer receiving carboplatin alone (300-400 mg m-2) and two men with testicular germ cell tumours receiving carboplatin (300 mg m2) with

A Randomised, Double-Blind, Parallel-Group Study to Compare the Efficacy and Safety of Ondansetron (GR38032F) plus Dexamethasone with Metoclopramide plus Dexamethasone in the Prophylaxis of Nausea and Emesis Induced by Carboplatin Chemotherapy

“…However, the results of this study show better efficacy than previously reported by Smith et al [6] and Harvey et al [7] where less than optimal doses of ondansetron com binations were administered. Similar results have, how ever, been observed in other studies where patients re ceived other non-cisplatin-based chemotherapy regimens.…”

“…Two small studies have also been reported, one conducted in the United Kingdom and one in New Zea land [6,7], which suggest that although good response rates were observed during the acute phase of treatment, some 40-50% of patients experienced prolonged symp toms of emesis over the 4 days following carboplatin che motherapy.…”

Pathophysiology, Severity, Pattern, and Risk Factors for Carboplatin-induced Emesis

“…Most of the patients suffered from severe emesis with a mean number of 13.5 vomiting episodes per patient. Data from 79 patients included in 3 anti-emetic trials using ondanse tron for the prevention of carboplatin-induced emesis were identified in a Medline literature search [11][12][13]. Although the numbers are small, there is clear evidence that ondansetron is efficacious in reducing carboplatin-induced emesis.…”

“…The publications of these stud ies of 'noncisplatin-induced emesis' do not provide enough detailed data for a subgroup analysis of carboplatin-treated patients. A Medline search revealed only 3 studies of anti-emetic treatment for patients receiving car boplatin [11][12][13] . 3).…”

Efficacy of Ondansetron Treatment with Different Timing Schedules: A Randomized Double–Blind Study

“…GR 38032F (ondansetron) is a selective serotonin sub type-3 receptor antagonist (5-HT;0, which has been pro posed to be effective in the prevention of nausea and vom iting associated with cisplatin and other chemotherapeu tic agents [1][2][3][4][5][6][7][8][9]. It is considered to be a major advance in the control of chemotherapy-induced emesis which is most severe and distressing in cisplatin-treated patients [10][11][12][13][14][15] but may also occur with other chemotherapy regi mens as well as radiotherapy and is paramount in the evaluation of patients for treatment of cancer [10][11][12][13][14][15].…”