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Related Experiment Videos

Delayed emesis following anticancer chemotherapy

M G Kris1, K M Pisters, L Hinkley

  • 1Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
|September 1, 1994
PubMed
Summary
This summary is machine-generated.

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Delayed chemotherapy-induced emesis remains a significant issue. Combination antiemetics, including a 5-HT3 antagonist, dexamethasone, and a benzodiazepine, offer the best protection against both acute and delayed vomiting.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Therapeutics

Background:

  • Delayed chemotherapy-induced emesis (CIE) is a primary concern as acute CIE control improves.
  • The exact mechanisms of delayed emesis are not fully understood.
  • Studies focus on cisplatin and anthracycline/cyclophosphamide regimens.

Purpose of the Study:

  • To evaluate antiemetic strategies for managing delayed chemotherapy-induced emesis.
  • To identify effective treatments beyond serotonin (5-HT3) receptor antagonists.

Main Methods:

  • Review of empirical trials and randomized, placebo-controlled studies.
  • Comparison of antiemetic efficacy, including metoclopramide, dexamethasone, and ondansetron.
  • Analysis of delayed emesis occurrence in relation to acute symptoms.

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Main Results:

  • Metoclopramide and dexamethasone showed benefit for delayed emesis post-cisplatin.
  • Ondansetron (a 5-HT3 antagonist) showed limited efficacy in similar trials.
  • Dexamethasone alone was more effective than ondansetron for delayed emesis after anthracycline/cyclophosphamide.

Conclusions:

  • Delayed emesis may be mediated by non-serotonergic pathways.
  • Combination therapy with a 5-HT3 antagonist, dexamethasone, and a benzodiazepine is recommended for comprehensive CIE control.
  • Further research into novel antiemetic targets is crucial for improving delayed symptom management.