Tropisetron plus haloperidol to ameliorate nausea and vomiting associated with high-dose alkylating agent cancer chemotherapy

Bregni, Marco; Siena, Salvatore; Nicola, Massimo Di; Bonadonna, Gianni; Gianni, Alessandro M.

doi:10.1016/0277-5379(91)90217-2

Cited by 36 publications

(9 citation statements)

References 13 publications

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“…Since the vomiting process seems too complex for us to expect a single receptor antagonist to prevent it totally, we combined haloperidol, a dopamine receptor antagonist, with granisetron, a 5-HT 3 antagonist. Although the antiemetic activity of haloperidol is weak at the dose used in the study, it has been reported to increase the activity of an 5-HT 3 antagonist without additional side-effects in highdose chemotherapy treated patients [2]. Some other studies suggest that when a dopamine D 2 antagonist is added to an antiserotoninic, antiemetic efficacy is higher in moderately and highly emetogenic chemotherapy [6,7].…”

Section: Discussionmentioning

confidence: 95%

The antiemetic efficacy of granisetron plus dexamethasone, haloperidol and loracepam in breast cancer patients treated with high-dose chemotherapy with peripheral blood stem-cell support

Climent

Palau

Ruı́z

et al. 1998

Supportive Care in Cancer

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There has recently been a marked trend to increasing dose intensity in cancer chemotherapy, with or without peripheral blood stem-cell support, which has been associated with a higher frequency of nausea and vomiting. Antiemetic treatment in this setting has not been extensively analysed. From October 1995 to January 1997, prevention of emesis with granisetron 3 mg/12 h i.v., dexamethasone 12 mg/24 h i.v., haloperidol 0.5 mg/12 h p.o., and loracepam I mg/24 h p.o. was instituted in 30 breast cancer patients treated with high-dose chemotherapy (a 4-day intravenous continuous infusion of cyclophosphamide 1500 mg/m2 per day, thio-TEPA 125 mg/m2 per day and carboplatin 200 mg/m2 per day).A total of 30% of the patients (9/30) obtained complete or major protection on the 4 days of chemotherapy treatment (96.7% (29/30) on day 1, 86.7% (26/30) on day 2, 70% (21/30) on day 3, and 50% (15/30) on day 4). On the days following chemotherapy, 46.7% (14/30) presented fewer than two emetic episodes on day 5, 70% (21/30) on day 6, 83.4% (25/30) on day 7 and, 93.3% (28/30) on day 8. This energic antiemetic combination treatment has hardly any effect in the prevention of emesis, providing complete or major protection of 30% for the 4 days of chemotherapy treatment. Further investigation aimed at improving antiemetic treatment results is necessary.

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Section: Discussionmentioning

confidence: 95%

The antiemetic efficacy of granisetron plus dexamethasone, haloperidol and loracepam in breast cancer patients treated with high-dose chemotherapy with peripheral blood stem-cell support

Climent

Palau

Ruı́z

et al. 1998

Supportive Care in Cancer

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“…Should ecacy be insucient despite combination treatment, additional treatment with a dopamine antagonist or a neuroleptic as rescue medication is available as an option [24,25].…”

Section: Prophylaxis Of Nausea and Emesismentioning

confidence: 99%

Treatment of chemotherapy-induced nausea and vomiting

Oettle

Riess

2001

Journal of Cancer Research and Clinical Oncology

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“…These drugs have optimized the treatment of acute chemotherapy-induced nausea and vomiting, but their effect in delayed emesis is less pronounced. Corticosteroids add to the antiemetic effect of highdose metoclopramide [16,26], and the efficacy of the selective serotonin antagonists is increased by both steroids [8,22,36,37] and dopamine antagonists [7,19,21] ( Table 1). A natural continuation of the clinical research would be an investigation of the combination of a serotonin antagonist, a steroid and a dopamine antagonist, and such studies have been initiated.…”

Section: Past Developmentmentioning

confidence: 99%

“…Interference with the "adrenergic system" Dopamine antagonists such as haloperidol [7] and metopimazine [19,21] have been able to improve the antiemetic effect of serotonin antagonists (Table 1). It is noteworthy that haloperidol and metopimazine are also potent a-adrenergic antagonists [20], a characteristic that might contribute not only to the adverse events, but also to the antiemetic effect of these drugs.…”

Section: New Perspectivesmentioning

confidence: 99%

New perspectives in antiemetic treatment

Herrstedt

1996

Support Care Cancer

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Though antiemetic therapy has improved markedly in the past 15 years, patients still regard nausea and vomiting as two of the most distressing adverse events during chemotherapy. A major progress was the development of the serotonin3 (5-HT3) receptor antagonists. A possible antiemetic effect, achieved by interference with the "serotonergic system", is not restricted to antagonism at 5-HT3 receptors, however, but also includes agonism at 5-HT1A and 5-HT2 receptors, and serotonin synthesis inhibitors. The number of receptors thought to be involved in the emetic reflex has been augmented by neurokinin1 receptors with substance P as the preferred ligand. Animal studies have demonstrated a broad antiemetic profile of substance P antagonists. The somatostatin analogue octreotide has an antiemetic effect in patients with gastrointestinal obstruction, but has not been investigated against chemotherapy-induced emesis. The next few years will disclose, whether the efficacy and safety profiles of one or more of these drugs will make it clinically useful in the treatment of chemotherapy-induced nausea and vomiting.

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Tropisetron plus haloperidol to ameliorate nausea and vomiting associated with high-dose alkylating agent cancer chemotherapy

Cited by 36 publications

References 13 publications

The antiemetic efficacy of granisetron plus dexamethasone, haloperidol and loracepam in breast cancer patients treated with high-dose chemotherapy with peripheral blood stem-cell support

The antiemetic efficacy of granisetron plus dexamethasone, haloperidol and loracepam in breast cancer patients treated with high-dose chemotherapy with peripheral blood stem-cell support

Treatment of chemotherapy-induced nausea and vomiting

New perspectives in antiemetic treatment

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