Comparison between Antiemetic Effects of Palonosetron and Granisetron on Chemotherapy-Induced Nausea and Vomiting in Japanese Patients Treated with R-CHOP

Biol Pharm Bull. 2017;40(9):1499-1505. doi: 10.1248/bpb.b17-00318.

Abstract

In the present study, the antiemetic effect of palonosetron, not combined with dexamethasone and aprepitant, on chemotherapy-induced nausea and vomiting was evaluated in patients with malignant lymphoma receiving first-line rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy, and was compared to that of granisetron. A total of 74 patients with non-Hodgkin lymphoma were included in this study (April 2007 to December 2015). Palonosetron (0.75 mg) or granisetron (3 mg) was intravenously administered before R-CHOP therapy. The proportions of patients with complete response (CR) during the overall (0-120 h after the start of R-CHOP therapy), acute (0-24 h) and delayed (24-120 h) phases were evaluated. CR was defined as no vomiting and no use of antiemetic rescue medication. A total of 32 and 42 patients were treated with palonosetron and granisetron, respectively. The CR rate in the palonosetron group was significantly higher than that in the granisetron group during the delayed phase (90.6 and 61.9%, respectively; p=0.007). Logistic regression analysis showed that use of palonosetron improved the CR rate during the delayed phase, compared to use of granisetron. Female sex, age less than 60 years, no habitual alcohol intake, and Eastern Cooperative Oncology Group performance status (ECOG-PS) score of 1 were significant risk factors associated with non-CR. The findings of this study suggested the superiority of palonosetron to granisetron, without accompanying dexamethasone and aprepitant, for chemotherapy-induced nausea and vomiting in patients with malignant lymphoma.

Keywords: chemotherapy-induced nausea and vomiting; complete response; delayed phase; granisetron; palonosetron.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aging
  • Antibodies, Monoclonal, Murine-Derived / adverse effects
  • Antiemetics / adverse effects
  • Antiemetics / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Asian People
  • Cyclophosphamide / adverse effects
  • Doxorubicin / adverse effects
  • Female
  • Granisetron / adverse effects
  • Granisetron / therapeutic use*
  • Humans
  • Isoquinolines / adverse effects
  • Isoquinolines / therapeutic use*
  • Lymphoma, Non-Hodgkin / complications
  • Lymphoma, Non-Hodgkin / drug therapy
  • Male
  • Middle Aged
  • Nausea / chemically induced*
  • Nausea / prevention & control*
  • Palonosetron
  • Prednisone / adverse effects
  • Quinuclidines / adverse effects
  • Quinuclidines / therapeutic use*
  • Risk Factors
  • Rituximab
  • Sex Characteristics
  • Treatment Outcome
  • Vincristine / adverse effects
  • Vomiting / chemically induced*
  • Vomiting / prevention & control*
  • Young Adult

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antiemetics
  • Isoquinolines
  • Quinuclidines
  • R-CHOP protocol
  • Rituximab
  • Palonosetron
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone
  • Granisetron