Effectiveness of palonosetron versus other serotonin 5-HT3 receptor antagonists in triple antiemetic regimens during multiday highly emetogenic chemotherapy [Efectividad de palonosetrón en comparación con otros antagonistas del receptor 5-HT3 en regímenes antieméticos triples durante la quimioterapia altamente emetogénica de varios días]

摘要

BACKGROUND: The second-generation serotonin 5-HT3 receptor antagonist palonosetron has shown improved efficacy in the prevention of both acute and delayed chemotherapy-induced nausea and vomiting (CINV). However, there have been no randomized controlled trials supporting the preferential use of palonosetron in triple antiemetic regimens for patients receiving multiday highly emetogenic chemotherapy (HEC). OBJECTIVE: To compare the effectiveness of palonosetron-based and firstgeneration 5-HT3 receptor antagonist-based triple antiemetic regimens in cancer patients receiving multiday HEC. METHODS: This was a review and analysis of medical record data. A total of 115 patients who had received multiday HEC were included and grouped into a palonosetron-based antiemetic group (n = 73) or a first-generation 5-HT3 receptor antagonist-based antiemetic group (n = 42). Data on CINV were collected in 24- hour intervals for 120 hours after the start of chemotherapy. RESULTS: Complete response rates did not differ significantly between the 2 groups during any of the 3 phases: acute (0-24 hours), p = 0.877; overlap (24- 120 hours), p = 0.997; and overall (0-120 hours), p = 0.723. The proportion of patients with complete control was similar between the groups during each phase: acute, p = 0.862; overlap, p = 0.838; and overall, p = 0.828. There was also no significant difference in other end points between the 2 groups. Among all patients, females experienced significantly more acute nausea (p = 0.040) and vomiting (p = 0.046) than males. Compared with nondrinkers, patients who consumed alcohol had a lower overall incidence of vomiting (p = 0.020). CONCLUSIONS: Within a triple antiemetic regimen, a palonosetron-based antiemetic regimen was not significantly different from regimens based on first-generation 5- HT3 receptor antagonists in preventing CINV during multiday HEC.