This report of a double-blind, randomized study performed to evaluate the comparative
antiemetic efficacy of
tropisetron (
Navoban; Sandoz Pharma Ltd, Basel, Switzerland), a new
5-hydroxytryptamine receptor antagonist, focuses on treatment during stages of
chemotherapy when
nausea and
vomiting are particularly severe. One hundred fifteen
chemotherapy-naive patients with malignant disease were administered either
tropisetron (n = 58) or a
dexamethasone dose plus a
metoclopramide dose (n = 57) during 5 days of two successive cycles of
chemotherapy. Within the first 24 hours after receiving
cisplatin-based
chemotherapy, 76% of patients in the
tropisetron group remained free of
vomiting (with 59% of patients free of
nausea) compared with 39% of patients free of
vomiting in the conventionally treated group (30% of patients free of
nausea). Improved control of
emesis also was observed over 4 consecutive days of follow-up in the
tropisetron group. The difference in incidence of
nausea and
vomiting between the patient groups was statistically significant (P < .05). The efficacy of
tropisetron was well maintained during the second consecutive
chemotherapy cycle; during the first 24 hours, 72% and 62% of patients remained free of
vomiting and
nausea, respectively.
Tropisetron appears to be a highly effective, well tolerated, and simple to use
antiemetic agent for patients receiving
chemotherapy.