Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Autografting

Palonosetron and dexamethasone for prevention of nausea and vomiting in patients receiving high-dose chemotherapy with auto-SCT

Abstract

The aim of this study was to determine the efficacy of palonosetron combined with dexamethasone in prevention of chemotherapy (CT)-induced nausea and vomiting (CINV) in patients receiving high-dose (HD)-CT with auto-SCT, and the efficacy of a second dose of palonosetron in treating breakthrough emesis. One hundred thirty-four patients treated with HD-CT and auto-SCT for hematologic malignancies received palonosetron as prophylaxis for CINV on the first day of conditioning; patients were also administered dexamethasone throughout the entire period of conditioning. If breakthrough emesis occurred, a second dose of palonosetron was administered at 72 h after the first administration. Complete response and complete protection were observed in 36 and 26% of patients, respectively. One-half of the patients, re-treated with palonosetron for breakthrough emesis, were successfully rescued. Treatment with palonosetron plus dexamethasone seems to be encouraging in terms of prophylaxis of CINV and treatment of breakthrough emesis in the setting of HD-CT.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Hesketh PJ, Kris MG, Grunberg SM, Beck T, Hainsworth JD, Harker G et al. Proposal for classifying the acute emetogenicity of cancer chemotherapy. J Clin Oncol 1997; 15: 103–109.

    Article  CAS  PubMed  Google Scholar 

  2. Osoba D, Zee B, Pater J, Warr D, Latreille J, Kaizer L . Determinants of postchemotherapy nausea and vomiting in patient with cancer. J Clin Oncol 1997; 15: 116–123.

    Article  CAS  PubMed  Google Scholar 

  3. Sun CC, Bodurka DC, Weaver CB, Rasu R, Wolf JK, Bevers MW et al. Rankings and symptom assessments of side effects from chemotherapy: insights from experienced patients with ovarian cancer. Support Care Cancer 2005; 13: 219–227.

    Article  PubMed  Google Scholar 

  4. Osoba D, Zee B, Warr D, Latreille J, Kaizer L, Pater J . Effect of post-chemotherapy nausea and vomiting on health related quality of life. Support Care Cancer 1997; 5: 307–313.

    Article  CAS  PubMed  Google Scholar 

  5. Roila F, Tonato M, Cognetti F, Cortesi E, Favalli G, Marangolo M et al. Prevention of DHAP-induced emesis: a double-blind multicenter randomized crossover study comparing ondansetron and ondansetron plus DHAP. J Clin Oncol 1991; 9: 675–678.

    Article  CAS  PubMed  Google Scholar 

  6. Latreille J, Stewart D, Laberge F, Hoskins P, Rusthoven J, McMurtrie E et al. DHAP improves the efficacy of granisetron in the first 24 h following high-dose DHAP chemotherapy. Support Care Cancer 1995; 3: 307–312.

    Article  CAS  PubMed  Google Scholar 

  7. Carmichael J, Bessell EM, Harris AL, Hutcheon AW, Dawes PJ, Daniels S et al. Comparison of granisetron alone and granisetron plus DHAP in the prophylaxis of cytotoxic-induced emesis. Br J Cancer 1994; 70: 1161–1164.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. The Italian Group for Antiemetic Research. DHAP, granisetron, or both for the prevention of nausea and vomiting during chemotherapy for cancer. N Engl J Med 1995; 332: 1–5.

    Article  Google Scholar 

  9. The Italian Group for Antiemetic Research. Ondansetron vs metoclopramide, both combined with DHAP, in the prevention of DHAP-induced delayed emesis. J Clin Oncol 1997; 15: 124–130.

    Article  Google Scholar 

  10. Aapro MS, Thuerlimann B, Sessa C, De Pree C, Bernhard J, Maibach R, Swiss Group for Clinical Cancer Research. A randomized double-blind trial to compare the clinical efficacy of granisetron with metoclopramide, both combined with DHAP in the prophylaxis of chemotherapy-induced delayed emesis. Ann Oncol 2003; 14: 291–297.

    Article  CAS  PubMed  Google Scholar 

  11. Pater JL, Lofters WS, Zee B, Dempsey E, Walde D, Moquin JP . The role of the 5-HT3 antagonist ondansetron and dolasetron in the control of delayed onset nausea and vomiting in patients receiving moderately emetogenic chemotherapy. Ann Oncol 1997; 8: 181–185.

    Article  CAS  PubMed  Google Scholar 

  12. Italian Group for Antiemetic Research. DHAP alone or in combination with ondansetron for the prevention of delayed nausea and vomiting induced by chemotherapy. N Engl J Med 2000; 342: 1554–1559.

    Article  Google Scholar 

  13. Gralla R, Lichinitser M, Van Der Vegt S, Sleeboom H, Mezger J, Peschel C et al. Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with ondansetron. Ann Oncol 2003; 14: 1570–1577.

    Article  CAS  PubMed  Google Scholar 

  14. Eisenberg P, Figueroa-Vadillo J, Zamora R, Charu V, Hajdenberg J, Cartmell A et al. Improved prevention of moderately emetogenic chemotherapy-induced nausea and vomiting with palonosetron, a pharmacologically novel 5-HT3 receptor antagonist: results of a phase III, single dose trial vs dolasetron. Cancer 2003; 98: 2473–2482.

    Article  CAS  PubMed  Google Scholar 

  15. Aapro MS, Grunberg SM, Manikhas GM, Olivares G, Suarez T, Tjulandin SA et al. A phase III, double-blind, randomized trial of palonosetron compared with ondansetron in preventing chemotherapy-induced nausea and vomiting following higly emetogenic chemotherapy. Ann Oncol 2006; 17: 1441–1449.

    Article  CAS  PubMed  Google Scholar 

  16. Hesketh PJ, Grunberg SM, Gralla RJ, Warr DG, Roila F, de Wit R et al. The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced, nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose DHAP—The aprepitant protocol 052 study group. J Clin Oncol 2003; 21: 4112–4119.

    Article  CAS  PubMed  Google Scholar 

  17. Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, Julie Ma G, Eldridge K, Hipple A et al. Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of the chemotherapy-induced nausea and vomiting. Cancer 2003; 97: 3090–3098.

    Article  CAS  PubMed  Google Scholar 

  18. Schmoll HJ, Aapro MS, Poli-Bigelli S, Kim HK, Park K, Jordan K et al. Comparison of an aprepitant regimen with a multiple-day ondansetron regimen, both with DHAP, for antiemetic efficacy in high-dose DHAP treatment. Ann Oncol 2006; 17: 1000–1006.

    Article  CAS  PubMed  Google Scholar 

  19. Warr DG, Hesketh PJ, Gralla RJ, Muss HB, Herrstedt J, Eisenberg PD et al. Efficacy and tolerability of aprepitant for the prevention of chemotherapy-induced nausea vomiting in patients with breast cancer after moderately emetogenic chemotherapy. J Clin Oncol 2005; 23: 2822–5851.

    Article  CAS  PubMed  Google Scholar 

  20. Sledge Jr GW, Einhorn L, Nagy C, House K . Phase III double-blind comparison of i.v. ondansetron and metoclopramide for patients receiving multiple-day DHAP based chemotherapy. Cancer 1992; 70: 2524–2528.

    Article  PubMed  Google Scholar 

  21. Noble A, Bremer K, Goedhals L, Cupissol D, Dilly SG . A double-blind, randomised crossover comparison of granisetron and ondansetron in 5-day fractionated chemotherapy: assessment of efficacy, safety, and patient preference. The Granisetron Study Group. Eur J Cancer 1994; 30A: 1083–1088.

    Article  CAS  PubMed  Google Scholar 

  22. Fox SM, Einhorn LH, Cox E, Powell N, Abdy A . Ondansetron vs ondansetron, DHAP, and chlopromazine in the prevention of nausea and vomiting associated with multiple-day DHAP chemotherapy. J Clin Oncol 1993; 11: 2391–2395.

    Article  CAS  PubMed  Google Scholar 

  23. Fauser AA, Pizzocaro G, Schueller J, Khayat D, Wilkinson P . A double-blind, randomised, parallel study comparing i.v. dolasetron plus DHAP and i.v. dolasetron alone for the management of fractionated DHAP-related nausea and vomiting. Support Care Cancer 2000; 8: 49–54.

    CAS  PubMed  Google Scholar 

  24. Viner CV, Selby PJ, Zulian GB, Gore ME, Butcher ME, Wootton CM et al. Ondansetron—a new safe and effective antiemetic in patient receiving high-dose melphalan. Cancer Chemother Pharmacol 1990; 25: 449–453.

    Article  CAS  PubMed  Google Scholar 

  25. Perez EA, Tiemeier T, Solberg LA . Antiemetic therapy for high-dose chemotherapy with transplantation: report of a retrospective analysis of a 5HT3 regimen and literature review. Support Care Cancer 1999; 7: 414–424.

    Article  Google Scholar 

  26. Abbott B, Ippoliti C, Bruton J, Neumann J, Whaley R, Champlin R . Antiemetic efficacy of granisetron plus DHAP in BM transplant patients receiving chemotherapy and TBI. BM Transplant 1999; 23: 265–269.

    CAS  Google Scholar 

  27. Ballen KK, Hesketh AM, Heyes C, Becker PS, Emmons RV, Fogarty K et al. Prospective evaluation of antiemetic outcome following high-dose chemotherapy with hematopoietic stem cell support. BM Transplant 2001; 28: 1061–1066.

    CAS  Google Scholar 

  28. Einhorn LH, Brames MJ, Dreicer R, Nichols CR, Cullen Jr MT, Bubalo J . Palonosetron plus DHAP for prevention of chemotherapy-induced nausea and vomiting in patients receiving multiple-day DHAP chemotherapy for germ cell cancer. Support Care Cancer 2007; 15: 1293–1300.

    Article  PubMed  Google Scholar 

  29. Musso M, Scalone R, Bonanno V, Crescimanno A, Polizzi V, Porretto F et al. Palonosetron (Aloxi) and DHAP for prevention of acute and delayed nausea and vomiting in patients receiving multiple-day chemotherapy. Support Care Cancer 2009; 17: 205–209.

    Article  PubMed  Google Scholar 

  30. Wong EH, Clark R, Leung E, Loury D, Bonhaus DW, Jakeman L et al. The interaction of RS 25259-197, a potent and selective antagonist, with 5-HT3 receptors, in vitro. Br J Pharmacol 1995; 114: 851–859.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Navari RM . Prevention of emesis from multiple-day and high-dose chemotherapy regimens. J Natl Compr Canc Netw 2007; 5: 51–59.

    Article  CAS  PubMed  Google Scholar 

  32. Kris MG, Hesketh PJ, Somerfield MR, Feyer P, Clark-Snow R, Koeller JM et al. American Society of Clinical Oncology guideline for antiemetics in oncology: update 2006. J Clin Oncol 2006; 24: 2932–2947.

    Article  CAS  PubMed  Google Scholar 

  33. The Antiemetic Subcommittee of the Multinational Association of Supportive Care in Cancer (MASCC). Prevention of chemotherapy- and radiotherapy-induced emesis: results of the 2004 Perugia International Antiemetic Consensus Conference. Ann Oncol 2006; 17: 20–28.

    Article  Google Scholar 

  34. López-Jiménez J, Martín-Ballesteros E, Sureda A, Uralburu C, Lorenzo I, del Campo R et al. Chemotherapy-induced nausea and vomiting in acute leukemia and stem cell transplant patients: results of a multicenter, observational study. Haematologica 2006; 91: 84–91.

    PubMed  Google Scholar 

  35. Rojas C, Stathis M, Thomas AG, Massuda EB, Alt J, Zhang J et al. Palonosetron exhibits unique molecular interactions with the 5-HT3 receptor. Anesth Analag 2008; 107: 469–478.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M Musso.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Musso, M., Scalone, R., Crescimanno, A. et al. Palonosetron and dexamethasone for prevention of nausea and vomiting in patients receiving high-dose chemotherapy with auto-SCT. Bone Marrow Transplant 45, 123–127 (2010). https://doi.org/10.1038/bmt.2009.114

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2009.114

Keywords

This article is cited by

Search

Quick links