Comparison of palonosetron and granisetron in triplet antiemetic therapy in nonmetastatic breast cancer patients receiving high emetogenic chemotherapy: a multicenter, prospective, and observational study

  • Murat ArazEmail author
  • Mustafa Karaagac
  • Levent Korkmaz
  • Lokman Koral
  • Fatih Inci
  • Ismail Beypinar
  • Mukremin Uysal
  • Mehmet Artac
Original Article



We aimed to investigate the efficacy of 0.25 mg dose of palonosetron and granisetron in triplet antiemetic prophylaxis in breast cancer patients receiving HEC.


Patients with nonmetastatic breast cancer who received HEC [doxorubicin or epirubicin plus cyclophosphamide (AC/EC)] were enrolled in the study. The prophylactic triplet antiemetic regimens were used according to the doctor’s preference during the first cycle of HEC as intravenous dexamethasone and palonosetron 0.25 mg or granisetron 3 mg on day 1 as well as oral aprepitant (125 mg on day 1 and 80 mg on days 2 and 3).The primary endpoint was complete response rate (CR) on acute and delayed chemotherapy-induced nausea and vomiting (CINV), separately.


A total of 118 female patients were included in the study. Patients received AC (83%), EC (3%), and dose-dense AC (14%) as adjuvant (88%) or neoadjuvant (12%). The majority of patients received palonosetron (59%) containing antiemetic treatment. The CR rate on acute and delayed vomiting was very high and not statistically different in both of the arms (acute 87% vs. 96%, p = 0.089; delayed 90% vs. 92%, p = 0.489), respectively. Nevertheless, the CR rate on either acute or delayed nausea was lower than vomiting (acute 51% vs. 51%; delayed 38% vs. 29%, p = 0.203; respectively).


This is the second study that compared a 0.25 mg dose of palonosetron with first-generation setron in triplet antiemetic prophylaxis in cancer patients receiving HEC. We could not find meaningful statistical differences between two arms, regarding CR rate on acute and delayed CINV.


Breast cancer Granisetron High emetogenic chemotherapy Palonosetron Triplet antiemetic 



We thank all patients for participating in the study. Any financial resource was not used for this work to be carried out.

Compliance with ethical standards

Conflict of interest

All of the authors declare that no any potential conflict of interest related to this manuscript. Any financial resource was not used for this work to be carried out.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medical OncologyNecmettin Erbakan University Meram Faculty of MedicineKonyaTurkey
  2. 2.Department of Medical OncologyCanakkale 18 Mart University Faculty of MedicineCanakkaleTurkey
  3. 3.Department of Medical OncologyKarabuk Education and Research HospitalKarabukTurkey
  4. 4.Department of Medical OncologyAfyon Kocatepe University Faculty of MedicineAfyonkarahisarTurkey

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