Effect of palonosetron in prevention of chemotherapy-induced vomiting

Objective To evaluate the efficacy and safety of palonosetron in prevention of chemothe-rapy-induced vomiting. Methods Using multi-center, randomized, double-blind, self-cross-over controlled clinical trial design, 149 cancer patients received 2 cycles chemotherapy including cisplatin or anthracycline continuously. All the patients were divided into moderately emetogenic group (cisplatin≤50 mg/m2 or doxorubicin≥40 mg/m2 or pirarubicin≥40 mg/m2 or epirubicin≥60 mg/m2) and highly emetogenic group (cisplatin≥60 mg/m2). All the patients received palonosetron or granisetron before chemotherapy respectively. If patients received palonosetron in the first cycles, the control drug granisetron would be used in the second cycles and vice versa. The complete control rates of acute vomiting and delayed vomiting, as well as the adverse effects of these antiemetic drugs in the experiment group and control group were observed. Results The complete control rate of acute vomiting between palonosetron cycles and granisetron cycles had no significant diffe-rence in moderately emetogenic group (50.72% vs. 48.00%, χ2=0.153, P=0.695) and highly emetogenic group (45.76% vs. 52.24%, χ2=0.924, P=0.337). In moderately emetogenic group, the complete control rate of delayed vomiting in palonosetron cycles was significantly higher than that in granisetron cycles (59.42% vs. 41.33%, χ2=4.673, P=0.031), while it had no significant difference in highly emetogenic group (37.29% vs. 28.36%, χ2=0.956, P=0.328). And in moderately emetogenic group, the frequency of vomiting in palonosetron cycles was significantly less than that in granisetron cycles during 24 hours to 5 days(Median 0.0 vs. Median 1.0, χ2=7.765, P=0.005). The adverse effects in the two cycles had a lower incidence and a lesser degree similarly. Conclusion Palonosetron has a definite effect in prevention of acute and delayed chemotherapy-induced vomiting. Especially it is superior to granisetron for delayed vomiting. And it has lower adverse effects, so it is worth spreading in clinic. Key words: Antineoplastic agents; Antiemetics; Vomiting; Palonosetron