Efficacy and Safety of 5-Hydroxytryptamine-3 Receptor Antagonists (5-HT3 RAs) for The Prevention of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients: A Review

Abstract

Objective: This review provides an update review of the efficacy and safety of 5-hydroxytryptamine-3 receptor antagonists in the prevention of chemotherapy-induced nausea and vomiting (CINV) in cancer patients.
 Methods: The information was collected from electronic scientific search engines from PubMed, Science Direct, Scopus, and Google Scholar. The publication dates covered were from 2010 to 2020. The primary endpoint was the percentage of patients who achieved a complete response (CR), complete control (CC), no nausea, no emesis, or no rescue medication.The secondary endpoint was the percentage of patients who experience constipation related to 5-HT RA constipation, headache, diarrhea, or dizziness, as well as changes in heart rhythm.
 Results: Fourteen articles were identified. Palonosetron has the same effectiveness as granisetron as but more effective than ondansetron in the delayed phase and overall. Adverse effects that often occur due to the use of palonosetron, granisetron, and ondansetron are constipation and headache. Some of the articles also mentioned that palonosetron does not cause changes in heart rhythm but granisetron and ondansetron do cause changes in the electrocardiogram (ECG) at certain doses.
 Conclusion: Palonosetron has the same effectiveness as granisetron, and more effective than ondansetron in delayed, and overall phases. The use of palonosetron, granisetron, and ondansetron cause constipation and headaches at all doses, palonosetron does not cause ECG abnormalities whereas granisetron and ondansetron cause ECG changes.
 Keywords: palonosetron, ondansetron, granisetron, 5-HT3 RAs, cancer, nausea, vomiting, CINV.