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Controlling emesis related to cancer therapy
1Centre Anticancereux, Switzerland.
European Journal of Cancer (Oxford, England : 1990)
|January 1, 1991
Summary
High-dose metoclopramide and dopamine antagonists control chemotherapy nausea and vomiting in 60-70% of patients. Specific 5-HT3 receptor antagonists offer similar control with fewer side effects.
Area of Science:
- Oncology
- Pharmacology
Background:
- Chemotherapy-induced nausea and vomiting (CINV) significantly impacts patient quality of life.
- High-dose cisplatin-based chemotherapy presents a substantial challenge for CINV management.
Purpose of the Study:
- To evaluate the efficacy and side effect profiles of different antiemetic strategies for high-dose chemotherapy.
- To compare dopamine antagonists/metoclopramide with 5-HT3 receptor antagonists in controlling CINV.
Main Methods:
- Review of existing literature on antiemetic treatments for high-dose cisplatin chemotherapy.
- Analysis of clinical data on the effectiveness and adverse events of metoclopramide, dopamine antagonists, and 5-HT3 receptor antagonists.
Main Results:
- Combinations of dopamine antagonists or high-dose metoclopramide with steroids achieve 60-70% control of CINV.
- High-dose metoclopramide's efficacy may stem from 5-HT3 antagonism but causes extrapyramidal side effects and sedation.
- Specific 5-HT3 receptor antagonists (ondansetron, granisetron, tropisetron) provide comparable CINV control with fewer side effects, primarily headache and constipation.
Conclusions:
- Specific 5-HT3 receptor antagonists are a favorable option for CINV management due to comparable efficacy and improved side effect profile.
- Combinations of 5-HT3 receptor antagonists with steroids offer a high level of protection against chemotherapy-induced nausea and vomiting.
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