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[Recent improvements in antiemetic therapy]

F Roila1, M A Palladino, G Ciccarese

  • 1Divisione Oncologia Medica, Ospedale Policlinico, Perugia, Italy.

Tumori
|January 1, 1997
PubMed
Summary

The 5-HT3 receptor antagonists and dexamethasone effectively prevent chemotherapy-induced nausea and vomiting. For delayed emesis, metoclopramide with dexamethasone is cost-effective, while ondansetron with dexamethasone is a suitable alternative.

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Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Medicine

Background:

  • Chemotherapy-induced nausea and vomiting (CINV) significantly impacts patient quality of life.
  • Recent advancements include 5-HT3 receptor antagonists and corticosteroids for CINV prevention.

Purpose of the Study:

  • To evaluate the efficacy of 5-HT3 receptor antagonists and dexamethasone in preventing acute and delayed CINV.
  • To compare different antiemetic regimens for cisplatin and moderately emetogenic chemotherapy.

Main Methods:

  • Review of clinical practice guidelines and double-blind comparative studies.
  • Analysis of intravenous and oral antiemetic combinations including 5-HT3 antagonists, dexamethasone, and metoclopramide.

Main Results:

  • Intravenous 5-HT3 antagonist plus dexamethasone is recommended for acute CINV from cisplatin and moderately emetogenic chemotherapy.
  • For delayed CINV from cisplatin, oral metoclopramide plus dexamethasone is cost-effective; ondansetron plus dexamethasone is an alternative.
  • Oral dexamethasone or ondansetron show efficacy for delayed CINV from moderately emetogenic chemotherapy, with selective treatment indicated.

Conclusions:

  • Combination therapy with 5-HT3 receptor antagonists and dexamethasone is crucial for managing CINV.
  • Cost-effectiveness and patient tolerance should guide the choice of antiemetic regimens for delayed CINV.

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