The efficacy of triplet antiemetic therapy with 0.75 mg of palonosetron for chemotherapy-induced nausea and vomiting in lung cancer patients receiving highly emetogenic chemotherapy
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Chemotherapy-induced nausea and vomiting (CINV) are some of the most problematic symptoms for cancer patients. Triplet therapy consisting of a 5HT3 receptor antagonist, aprepitant, and dexamethasone is a guideline-recommended antiemetic prophylaxis for highly emetogenic chemotherapy (HEC). The efficacy and safety of triplet therapy using a 0.75-mg dose of palonosetron have not yet been investigated. We performed a prospective phase II study using triplet antiemetic therapy with 0.75 mg of palonosetron.
Chemotherapy-naïve lung cancer patients scheduled to receive HEC were enrolled. The eligible patients were pretreated with antiemetic therapy consisting of the intravenous administration of 0.75 mg of palonosetron, and 9.9 mg of dexamethasone and the oral administration of 125 mg of aprepitant on day 1, followed by the oral administration of 80 mg of aprepitant on days 2–3 and the oral administration of 8 mg of dexamethasone on days 2–4. The primary endpoint was the complete response rate (the CR rate; no vomiting and no rescue medication) during the overall phase (0–120 h).
The efficacy analysis was performed in 63 patients. The CR rates during the overall, acute and delayed phases were 81.0, 96.8, and 81.0 %, respectively. The no nausea and no significant nausea rate during the overall phase were 54.0 and 66.7 %, respectively. The most common adverse event was grade 1 or 2 constipation.
Triplet antiemetic therapy using a 0.75-mg dose of palonosetron shows a promising antiemetic effect in preventing CINV in lung cancer patients receiving HEC.
KeywordsCINV Highly emetogenic chemotherapy Palonosetron Aprepitant
This study was conducted by the Niigata Lung Cancer Treatment Group. The authors are thankful to the participating institutions and the following collaborating investigators: Koh Sato, Satoshi Hokari, Nao Koshio, Jun Koshio, Kosuke Ichikawa, and Toshiki Furukawa (Niigata University Medical and Dental Hospital); Masachika Hayashi and Hideki Kuriyama (Nagaoka Red Cross Hospital); Junichi Tanaka and Akira Hirata (Niigata Prefectural Shibata Hospital); Katsunori Kawamkami, Takahiro Miyabayashi, and Takashi Ishida (Niigata Prefectural Central Hospital); Junko Baba, Yoshiki Hayashi, Toru Hiura, and Tetsuya Abe (Niigata Cancer Center Hospital); Takeshi Ota and Akira Ishida (Nagaoka Chuo General Hospital); Naoya Matsumoto (Nishi-Niigata Chuo National Hospital); Syotetsu Kawabe and Masaki Terada (Saiseikai Niigata Daini Hospital); Yuka Kimura, Takafumi Tezuka, Kazuhiko Ito, and Hiroki Tsukada (Niigata City General Hospital); Yuichi Shimaoka (Niigata Prefectural Koide Hospital); and Koki Matsuyama (Niigata Prefectural Yoshida Hospital). We would like to thank Kumiko Shirai from the Bioscience Medical Research Center at Niigata University Medical and Dental Hospital for her support in data collection and management.
Conflict of interest
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