Efficacy of Single-dose First-generation 5-HT 3 Receptor Antagonist and Dexamethasone for Preventing Nausea and Vomiting Induced by Low-dose Carboplatin-based Chemotherapy

• Published in: Anticancer research 2017-04, Vol.37 (4), p.1965
• Main Authors: Kaito, Daizo, Iihara, Hirotoshi, Funaguchi, Norihiko, Endo, Junki, Ito, Fumitaka, Yanase, Komei, Toyoshi, Sayaka, Sasaki, Yuka, Hirose, Chiemi, Arai, Natsumi, Kitahora, Mika, Ohno, Yasushi, Itoh, Yoshinori, Minatoguchi, Shinya
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - pathology; Adult; Aged; Aged, 80 and over; Antiemetics - therapeutic use; Antineoplastic Agents - adverse effects; Carboplatin - adverse effects; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - pathology; Dexamethasone - therapeutic use; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Male; Middle Aged; Nausea - chemically induced; Nausea - drug therapy; Neoplasm Staging; Prognosis; Receptors, Serotonin, 5-HT3 - chemistry; Retrospective Studies; Risk Assessment; Serotonin 5-HT3 Receptor Antagonists - therapeutic use; Vomiting - chemically induced; Vomiting - drug therapy
• ISSN: 1791-7530

Carboplatin (CBDCA) is known to exhibit a high emetic risk among moderate-emetic risk anticancer drugs, and the dose of CBDCA varies in different therapies. In concurrent chemoradiotherapy (CCRT) for non-small cell lung cancer (NSCLC), the weekly administration of CBDCA (area under the curve (AUC) 2 mg/ml/min) and paclitaxel (PTX: 40 mg/m ) is frequently applied as standard therapy. However, the optimal antiemetic measures in the use of such low-dose CBDCA remain unclear. In this study, we retrospectively assessed the antiemetic effect of a single-dose of a first-generation 5-hydroxytryptamine-3 receptor antagonist (5-HT RA) and dexamethasone in the weekly CBDCA+PTX therapy in CCRT. The subjects were patients with NSCLC who were administered weekly CBDCA+PTX therapy in CCRT between January 2011 and December 2016 at our Department. As an antiemetic measure, a first-generation 5-HT RA, azasetron (10 mg, orally) or granisetron (3 mg, intravenously), and dexamethasone (9.9 mg, intravenously) were administered on day 1. The patients were evaluated for the following efficacy end-points for the first cycle: Complete response (CR; defined as no vomiting or retching episodes with no rescue medication) in the acute phase (0-24 hours), delayed phase (>24-120 hours), and overall phase (0-120 hours). Other efficacy endpoints evaluated were no vomiting or retching, and no nausea in all phases. The subjects we assessed in this study were 46 patients who were administered weekly CBDCA+PTX therapy in CCRT. For the overall, acute, and delayed phases, the complete response rates were 89.1%, 100%, and 89.1%, respectively. The rate of no nausea in the overall, acute, and delayed phases was 78.3%, 100%, and 78.3%, respectively. The rate of no vomiting in the overall, acute, and delayed phases was 95.7%, 100%, and 95.7%, respectively. A single dose of a first-generation 5-HT RA and dexamethasone had a favorable suppressive effect on nausea and vomiting in weekly CBDCA+PTX therapy for NSCLC.