Infusion of Palonosetron Plus Dexamethasone for the Prevention of Chemotherapy-Induced Nausea and Vomiting

Julio Hajdenberg, MD, Thomas Grote, MD, Lorrin Yee, MD, Roberto Arevalo-Araujo, MD, and Laurie A. Latimer, MS

M. D. Anderson Cancer Center, Orlando, Florida; Derrick L. Davis Forsyth Regional Cancer Center, Winston-Salem, North Carolina; Northwest Medical Specialties PLLC, Tacoma, Washington; Pasco-Pinellas Cancer Center, New Port Richey, Florida; and MGI PHARMA, INC., Bloomington, Minnesota

Serotonin (5-HT₃) receptor antagonists are the foundation of standard antiemetic care for cancer patients receiving emetogenic chemotherapy. To enhance the effi cacy of these supportive care agents, dexamethasone is routinely admixed with the 5-HT₃ receptor antagonist, which is administered by intravenous infusion before chemotherapy begins. This phase II study evaluated the safety and efficacy of intravenous palonosetron admixed with dexamethasone to prevent chemotherapyinduced nausea and vomiting (CINV) in patients receiving moderately emetogenic chemotherapy. Cancer patients received palonosetron 0.25 mg plus dexamethasone 8 mg admixed in 50 mL of infusion solution before receiving at least one qualifying chemotherapeutic agent (cyclophosphamide £ 1,500 mg/m², doxorubicin ³ 20 mg/m², carboplatin, or oxaliplatin). Patients used diaries to record nausea and emesis experienced and rescue medications used. Of 32 participants, 27 (84%) had a complete response (no emesis and no rescue medication) during the acute (0–24 hours) interval posttherapy, 19 (59%) had a complete response during the delayed (> 24–120 hours) posttherapeutic interval, and 19 (59%) had a complete response during the overall (0–120 hours) posttreatment interval. A total of 23 patients (72%) had no emetic episodes, 16 (50%) had no nausea, and 21 (66%) used no rescue medication throughout the overall 5-day interval. The combination was well tolerated. Palonosetron plus dexamethasone given as a pretreatment infusion is effective and safe in preventing acute and delayed CINV in patients receiving moderately emetogenic chemotherapy.

J Support Oncol 2006;4:467–471 print e-mail full text 110 kb