[Efficacy of ondansetron in acute and delayed cisplatin-induced nausea and vomiting]

Nausea and vomiting have always been associated with anti-cancer agents in patients' minds because these effects were the main ones to occur during chemotherapy. Since 1990, a novel class of antiemetic agents has been available: the 5-HT3 serotonin receptors antagonists. Several randomised, international phase III studies have been carried out with ondansetron, the first compound of this therapeutic agent class. Today, the combination of ondansetron with corticosteroids appears to be one of the most efficient antiemetic treatment for high-dose cisplatin acute induced emesis and can be therefore considered as a reference treatment for acute cisplatin-induced emesis, cisplatin being the most emetogenic cytotoxic drug. A complete control (0 emetic episode) reached at the first course allows the maintenance of the efficacy over repeated courses for the majority of patients. In delayed emesis (24 hours after the start of chemotherapy), it is believed that the serotonin is not the only neuromediator involved in the mechanism.