Intravenous ondansetron plus intravenous dexamethasone with different ondansetron dosing schedules during multiple cycles of cisplatin-based chemotherapy.

Abstract

BACKGROUND:

This study examined whether different ondansetron dosing schedules plus dexamethasone influenced antiemetic efficacy during multiple cycles of cisplatin-based chemotherapy (CT). Antiemetic activities between previous CT and subsequent cycles were compared.

METHODS:

The cross-over study involved 424 patients. Arm A, three doses of 8 mg ondansetron given intravenously (IV) at 4-hourly intervals plus dexamethasone 20 mg IV at the start of CT, followed by dexamethasone 5 mg IV every 12 hours. Arm B, as arm A but the three doses of 8 mg ondansetron were given at 24-hourly intervals. For those with complete protection from emesis in both arms, a single dose of 8 mg ondansetron (arm C) was tried during the following CT. Once complete protection of emesis could not be maintained, arm A regimens were administered in the subsequent cycles of CT.

RESULTS:

There were 384, 377 and 147 patients in arm A, arm B and arm C, respectively. Complete control of acute and delayed nausea/vomiting obtained in arm A were 91.4%/94.8% and 59.6%/70.1%, and in arm B were 90.4%/92.3% and 61.3% 72.7%. There was no significant difference in antiemetic efficacy between both arms. Decreased incidence of and delayed onset of nausea on day 2 were observed in arm B (p = 0.002). The emetic severity during previous CT correlated significantly with those of the subsequent CT. The complete control of nausea/vomiting was maintained in 81.6%/72.1% of arm C patients during the following 3rd-6th cycles of CT.

CONCLUSION:

No difference in antiemetic efficacy was shown when a triple 8 mg dose of ondansetron was given at 4-hourly intervals or at 24-hourly intervals. However, the latter improved nausea on day 2. A single 8 mg dose of ondansetron can maintain antiemetic efficacy in the majority of complete responders in arm A and arm B.

• Authors: Ping-Tsung Chen, Chuang-Chi Liaw
• Journal: Chang Gung medical journal (Chang Gung Med J) 2008 Mar-Apr Vol. 31 Issue 2 Pg. 167-74 ISSN: 2072-0939 [Print] China (Republic : 1949- )
• PMID: 18567417 (Publication Type: Journal Article)

Chemical References

• Antiemetics
• Antineoplastic Agents
• Serotonin Antagonists
• Ondansetron
• Dexamethasone
• Cisplatin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antiemetics (administration & dosage)
• Antineoplastic Agents (adverse effects)
• Cisplatin (adverse effects)
• Cross-Over Studies
• Dexamethasone (administration & dosage, adverse effects)
• Female
• Humans
• Male
• Middle Aged
• Ondansetron (administration & dosage, adverse effects)
• Prospective Studies
• Serotonin Antagonists (administration & dosage)
• Vomiting (chemically induced, prevention & control)