For persons receiving chemotherapy of high emetic risk , there is no group of patients for whom agents of lower therapeutic index are appropriate first-choice antiemetics .
In all patients receiving cisplatin and all other agents of high emetic risk , the two-drug combination of dexamethasone and aprepitant is recommended for the prevention of delayed emesis .
The Up date Committee no longer recommends the combination of a 5-HT3 serotonin receptor antagonist and dexamethasone for the prevention of delayed emesis after chemotherapeutic agents of high emetic risk .
PURPOSE To up date the 1999 American Society of Clinical Oncology guideline for antiemetics in oncology .
Ondansetron compared with dexamethasone and metoclopramide as antiemetics in the chemotherapy of breast cancer with cyclophosphamide, methotrexate, and fluorouracil.
BACKGROUND Although ondansetron was found to be effective as an antiemetic in numerous clinical trials of highly emetogenic combination-chemotherapy regimens that included cisplatin , its role in milder emetogenic regimens has not been fully defined . To address its use with a widely used but less emetogenic regimen , we performed a double-blind , r and omized clinical trial comparing ondansetron with dexamethasone and metoclopramide in patients with breast cancer receiving chemotherapy with cyclophosphamide , methotrexate , and fluorouracil . METHODS A total of 165 women with breast cancer from 14 Canadian centers who were about to receive this chemotherapy for the first time were r and omly assigned to receive either ondansetron ( n = 85 ) or dexamethasone plus metoclopramide ( n = 80 ) , a widely used , st and ard antiemetic regimen . The patients recorded the incidence of nausea , emesis , and other side effects in diaries , and these data were compared in the two groups . RESULTS The patients who received dexamethasone and metoclopramide had significantly less nausea during the first 24 hours after chemotherapy was begun . Otherwise , there were no statistically significant differences in efficacy between the regimens . The incidence of drowsiness and increased appetite was higher in the group given dexamethasone and metoclopramide . CONCLUSIONS For women with breast cancer who are being treated with cyclophosphamide , methotrexate , and fluorouracil , the efficacy of dexamethasone and metoclopramide in controlling nausea and vomiting equaled or exceeded that of ondansetron
For persons receiving chemotherapy of high emetic risk , there is no group of patients for whom agents of lower therapeutic index are appropriate first-choice antiemetics .
In all patients receiving cisplatin and all other agents of high emetic risk , the two-drug combination of dexamethasone and aprepitant is recommended for the prevention of delayed emesis .
The Up date Committee no longer recommends the combination of a 5-HT3 serotonin receptor antagonist and dexamethasone for the prevention of delayed emesis after chemotherapeutic agents of high emetic risk .
PURPOSE To up date the 1999 American Society of Clinical Oncology guideline for antiemetics in oncology .