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 .
Open-label comparison of the antiemetic efficacy of single intravenous doses of dolasetron mesylate in pediatric cancer patients receiving moderately to highly emetogenic chemotherapy.
BACKGROUND Nausea and vomiting are among the most unpleasant adverse side effects of cancer therapy . PROCEDURE An open-label dose-escalation study was conducted to assess the appropriate intravenous dose of dolasetron for pediatric patients undergoing chemotherapy . Patients received dolasetron in single intravenous doses of 0.6 ( n = 10 ) , 1.2 ( n = 12 ) , 1.8 ( n = 12 ) , or 2.4 ( n = 12 ) mg/kg 30 min before receiving emetogenic chemotherapy .  Pharmacokinetic parameters were evaluated at each dose level and efficacy was evaluated over the first 24 hr following the administration of dolasetron . RESULTS A complete response was achieved in 10 % of patients given 0.6 mg/kg , 25 % of patients given 1 . 2 mg/kg , 67 % of patients given 1.8 mg/kg , and 33 % of patients given 2.4 mg/kg . Peak plasma concentrations ( Cmax ) were observed between 0 . 33 and 0.75 hr following dolasetron infusion . Cmax and area under plasma concentration-time ( AUC ) increased with larger doses of dolasetron , while terminal disposition half-life ( t1/2 ) and apparent clearance ( Clapp ) were not significantly changed with respect to dose . For 1.8-mg/kg dolasetron , the t1/2 was 4.98 hr and the maximum plasma concentration ( tmax ) 0.47 hr . Adverse events were mild to moderate . No serious events occurred . Conclusions . This study suggests that a single intravenous dose of 1.8 mg/kg is the optimum single intravenous dose for controlling chemotherapy-induced emesis in pediatric patients
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 .