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The efficacy of triplet antiemetic therapy with 0.75 mg of palonosetron for chemotherapy-induced nausea and vomiting in lung cancer patients receiving highly emetogenic chemotherapy

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Abstract

Background

Chemotherapy-induced nausea and vomiting (CINV) are some of the most problematic symptoms for cancer patients. Triplet therapy consisting of a 5HT3 receptor antagonist, aprepitant, and dexamethasone is a guideline-recommended antiemetic prophylaxis for highly emetogenic chemotherapy (HEC). The efficacy and safety of triplet therapy using a 0.75-mg dose of palonosetron have not yet been investigated. We performed a prospective phase II study using triplet antiemetic therapy with 0.75 mg of palonosetron.

Methods

Chemotherapy-naïve lung cancer patients scheduled to receive HEC were enrolled. The eligible patients were pretreated with antiemetic therapy consisting of the intravenous administration of 0.75 mg of palonosetron, and 9.9 mg of dexamethasone and the oral administration of 125 mg of aprepitant on day 1, followed by the oral administration of 80 mg of aprepitant on days 2–3 and the oral administration of 8 mg of dexamethasone on days 2–4. The primary endpoint was the complete response rate (the CR rate; no vomiting and no rescue medication) during the overall phase (0–120 h).

Results

The efficacy analysis was performed in 63 patients. The CR rates during the overall, acute and delayed phases were 81.0, 96.8, and 81.0 %, respectively. The no nausea and no significant nausea rate during the overall phase were 54.0 and 66.7 %, respectively. The most common adverse event was grade 1 or 2 constipation.

Conclusions

Triplet antiemetic therapy using a 0.75-mg dose of palonosetron shows a promising antiemetic effect in preventing CINV in lung cancer patients receiving HEC.

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Acknowledgments

This study was conducted by the Niigata Lung Cancer Treatment Group. The authors are thankful to the participating institutions and the following collaborating investigators: Koh Sato, Satoshi Hokari, Nao Koshio, Jun Koshio, Kosuke Ichikawa, and Toshiki Furukawa (Niigata University Medical and Dental Hospital); Masachika Hayashi and Hideki Kuriyama (Nagaoka Red Cross Hospital); Junichi Tanaka and Akira Hirata (Niigata Prefectural Shibata Hospital); Katsunori Kawamkami, Takahiro Miyabayashi, and Takashi Ishida (Niigata Prefectural Central Hospital); Junko Baba, Yoshiki Hayashi, Toru Hiura, and Tetsuya Abe (Niigata Cancer Center Hospital); Takeshi Ota and Akira Ishida (Nagaoka Chuo General Hospital); Naoya Matsumoto (Nishi-Niigata Chuo National Hospital); Syotetsu Kawabe and Masaki Terada (Saiseikai Niigata Daini Hospital); Yuka Kimura, Takafumi Tezuka, Kazuhiko Ito, and Hiroki Tsukada (Niigata City General Hospital); Yuichi Shimaoka (Niigata Prefectural Koide Hospital); and Koki Matsuyama (Niigata Prefectural Yoshida Hospital). We would like to thank Kumiko Shirai from the Bioscience Medical Research Center at Niigata University Medical and Dental Hospital for her support in data collection and management.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata, Japan

    Satoru Miura, Masaaki Okajima, Hiroshi Kagamu & Ichiei Narita

  2. Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, 951-8510, Japan

    Satoshi Watanabe & Hirohisa Yoshizawa

  3. Department of Respiratory Medicine, Nagaoka Red Cross Hospital, Nagaoka, Japan

    Kazuhiro Sato

  4. Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata, Japan

    Masato Makino

  5. Department of Internal Medicine, Niigata Prefectural Central Hospital, Joetsu, Japan

    Osamu Kobayashi

  6. Department of Respiratory Medicine, Nishi-Niigata Chuo National Hospital, Niigata, Japan

    Hiromi Miyao

  7. Department of Respiratory Medicine, Nagaoka Chuo General Hospital, Nagaoka, Japan

    Akira Iwashima

  8. Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Junta Tanaka

  9. Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan

    Hiroshi Tanaka & Akira Yokoyama

Authors
  1. Satoru Miura
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  2. Satoshi Watanabe
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  3. Kazuhiro Sato
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  4. Masato Makino
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  5. Osamu Kobayashi
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  6. Hiromi Miyao
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  7. Akira Iwashima
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  8. Masaaki Okajima
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  9. Junta Tanaka
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  10. Hiroshi Tanaka
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  11. Hiroshi Kagamu
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  12. Akira Yokoyama
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  13. Ichiei Narita
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  14. Hirohisa Yoshizawa
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Corresponding author

Correspondence to Hirohisa Yoshizawa.

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Miura, S., Watanabe, S., Sato, K. et al. The efficacy of triplet antiemetic therapy with 0.75 mg of palonosetron for chemotherapy-induced nausea and vomiting in lung cancer patients receiving highly emetogenic chemotherapy. Support Care Cancer 21, 2575–2581 (2013). https://doi.org/10.1007/s00520-013-1835-2

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  • DOI: https://doi.org/10.1007/s00520-013-1835-2

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