Does a single dose of palonosetron have any role in preventing acute chemotherapy-induced nausea and vomiting in pediatric osteosarcoma patients without dexamethasone? A randomized clinical trial.

Abstract

BACKGROUND:

Chemotherapy-induced nausea and vomiting (CINV) is a troublesome side-effect of chemotherapy in pediatric patients undergoing osteosarcoma treatment. In this context, the role of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists needs to be explored.

OBJECTIVES:

To evaluate the superiority of single-dose palonosetron over granisetron in pediatric patients undergoing highly emetogenic chemotherapy (HEC) for osteosarcoma.

MATERIAL AND METHODS:

In this double-blind, randomized study, pediatric patients were assessed in terms of acute nausea and vomiting following HEC for osteosarcoma. These children were assigned to group 1 (palonosetron) and group 2 (granisetron) without any other antiemetic prophylaxis. The primary outcome variable was the children's segment with a complete response (CR) during the acute phase of the 1st on-study chemotherapy cycle. The risk factors associated with the emesis were analyzed. The patients were followed up for the first 24 h after chemotherapy.

RESULTS:

A total number of 200 children were evaluated in terms of the response, and other factors that might alter the response were assessed in the 2 groups. These 200 children underwent 604 blocks of chemotherapy. Complete responses were documented in 83% and 72% of children receiving palonosetron and granisetron, respectively, during the acute phase. Only dexamethasone, used as a rescue medication, was found to be a significant risk factor that predisposed to the response (p < 0.05).

CONCLUSIONS:

Single-dose palonosetron is an effective alternative to granisetron for preventing CINV in children receiving HEC for osteosarcoma.

• Authors: Zheng Li, Chun Li, Ping Li, Yugang Li, Jin Lai, Sanjay Rastogi
• Journal: Advances in clinical and experimental medicine : official organ Wroclaw Medical University (Adv Clin Exp Med) Vol. 31 Issue 3 Pg. 223-230 (Mar 2022) ISSN: 1899-5276 [Print] Poland
• PMID: 35302300 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Antineoplastic Agents
• Isoquinolines
• Quinuclidines
• Palonosetron
• Dexamethasone

Topics

• Antineoplastic Agents (adverse effects, therapeutic use)
• Child
• Dexamethasone (therapeutic use)
• Humans
• Isoquinolines (therapeutic use)
• Nausea (chemically induced, drug therapy, prevention & control)
• Osteosarcoma (chemically induced, drug therapy)
• Palonosetron (therapeutic use)
• Quinuclidines (therapeutic use)
• Vomiting (chemically induced, drug therapy, prevention & control)