Abstract
Purpose: There is room for discussion of the optimal method of antiemetic therapy in moderately emetogenic chemotherapy (MEC). We compared palonosetron (Palo) and Dexamethasone (Dex) with fosaprepitant (Fapr), granisetron (Gran) and Dex as antiemetic therapies in MEC.Methods: We enrolled 15 patients who underwent the MEC for the first time in our hospital between April 2013 and January 2014. Participants were randomized to the group preceding Fapr + Gran + Dex therapy and Palo + Dex therapy as a cross-over design. The patients underwent both therapies at the end of the second course. On day 1, we administrated Fapr 150mg, Dex 4.95mg, Gran 3mg in the Fapr + Gran + Dex therapy, and Palo 0.75mg, Dex 9.9mg in the Palo + Dex therapy. We used the Japanese version of MAT (MASCC Antiemesis Tool), and evaluated mainly the Complete Response rate of vomiting (CR rate) of every day for 5 days from the start of the treatment. We also evaluated the Complete Control rate of emetic events (CC rate) and the Total Control rate of nausea and vomiting (TC rate).Results: Full 5 day CR rates were 66.7% (Palo + Dex therapy) and 73.3% (Fapr + Gran + Dex therapy) (P = 0.690). CC rate were 53.3% and 66.7% (P = 0.456), TC rates were 46.7% and 60.0% (P = 0.464). We observed a tendency of Fapr + Gran + Dex therapy being better than Palo + Dex therapy in all evaluation points.Conclusion: It has been suggested that the three-drug combination therapy of Fapr + Gran + Dex might be superior to the two-drug combination therapy including Palo as antiemetic therapy in MEC. We will continue collecting data and studying the problem in more detail.
Published Version
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