Introduction: the clinical challenge

In summary, ondansetron has proved to be a highly effective anti-emetric and is superior to metoclopramide in the treatment of acute emesis. The results in delayed emesis are less consistent, with superiority demonstrated in both non-cisplatin and radiotherapy studies, but rather equivocal results in cisplatin studies to date. Ondansetron exhibits minimal toxicity with no reported acute dystonic effects. This clearly is an obvious benefit - particularly in young patients. In three of the trials there was a crossover design which generated patient preference data (Table 5). Nausea and vomiting are very distressing but not life-threatening side effects; they are side effects to be tolerated by patients embarking on potentially curative chemotherapy. In the final analysis, patient preferences for a specific anti-emetic may well be one of the most important parameters by which a new anti-emetic should be judged. Since the London symposium, ondansetron has been introduced in the UK and New Zealand (Trademark ZOFRAN) and France (Trademark ZOPHREN). The objective of a satellite symposium to the 15th International Cancer Congress, Hamburg, held in August 1990, was to review new studies involving ondansetron and evaluate the clinical performance in a database of more than 5,500 cancer patients, including a significant paediatric contribution.