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Related Experiment Videos

Are there differences among the serotonin antagonists?

M Tonato1, F Roila, A Del Favero

  • 1Medical Oncology Division, Policlinco Hospital, Perugia, Italy.

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
|September 1, 1994
PubMed
Summary
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Serotonin-receptor (5-HT3) antagonists like ondansetron, granisetron, and tropisetron show similar clinical effectiveness in preventing chemotherapy-induced nausea and vomiting. Cost may become a deciding factor for these antiemetic drugs.

Area of Science:

  • Pharmacology
  • Oncology
  • Clinical Therapeutics

Background:

  • Serotonin-receptor (5-HT3) antagonists combined with dexamethasone are standard for preventing cisplatin-induced emesis.
  • Several 5-HT3 antagonist drugs are available, raising questions about optimal selection.
  • Preclinical studies suggest differences in potency, duration, and selectivity among ondansetron, granisetron, and tropisetron.

Purpose of the Study:

  • To compare the clinical antiemetic activity and tolerability of marketed 5-HT3 antagonists.
  • To address the dilemma of drug preference among ondansetron, granisetron, and tropisetron for managing chemotherapy-induced emesis.

Main Methods:

  • Review of preclinical data on 5-HT3 antagonist properties.
  • Analysis of existing, albeit limited and methodologically diverse, clinical comparative studies.

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  • Consideration of ongoing large-scale, independent clinical trials.

    • Main Results:

    • Preclinical differences in potency and selectivity among ondansetron, granisetron, and tropisetron do not appear to translate to significant clinical differences.
    • Current comparative studies, despite limitations, suggest similar antiemetic activity and tolerability for these drugs.
    • Ongoing large trials aim to detect smaller, clinically significant differences in efficacy.

    Conclusions:

    • Based on current evidence, the choice among ondansetron, granisetron, and tropisetron may hinge on cost-effectiveness.
    • Further large, methodologically sound studies are required to definitively guide clinical preference.
    • Future research focuses on identifying subtle but clinically meaningful differences in antiemetic protection.