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 .
Safety, tolerability, antiemetic efficacy, and pharmacokinetics of oral dolasetron mesylate in pediatric cancer patients receiving moderately to highly emetogenic chemotherapy.
PURPOSE The safety , antiemetic efficacy , and pharmacokinetics of single oral doses of dolasetron , a new highly selective 5-HT3 receptor antagonist , were evaluated in children with cancer undergoing treatment with moderately to highly emetogenic chemotherapy .  PATIENTS AND METHODS A total of 32 children , ages 3 to 18 years , were enrolled in a nonr and omized , multicenter , open-label , dose-escalation study . Three oral dose levels ( 0.6 , 1.2 , or 1.8 mg/kg ) were studied . Safety , efficacy , and pharmacokinetic parameters were assessed over 24 hours at each dosage level . RESULTS The most effective dose was 1.8 mg/kg ; 60 % of the patients achieved a complete or major response ( < or = 2 emetic episodes in 24 hours ) . A complete response was achieved in 3 of 9 patients ( 33 % ) who received 0.6 mg/kg , 4 of 13 ( 31 % ) patients who received 1.2 mg/kg , and 5 of 10 ( 50 % ) patients who received 1.8 mg/kg of dolasetron . Overall , dolasetron was well tolerated . Adverse events were mild and similar to those reported in adults . Peak plasma concentrations ( Cmax ) of dolasetron 's active reduced metabolite , MDL 74,156 , were dose proportional and occurred , on the average , within 1 hour of oral administration . The half-life ( t1/2 ) in plasma was approximately 6 hours for all dose levels , and the mean clearance ( CLapp ) was unrelated to dose . CONCLUSIONS Oral dolasetron is safe and effective in reducing chemotherapy-induced nausea and vomiting , particularly at the 1.8-mg/kg dose level . These results support further evaluation of oral dolasetron in larger r and omized clinical trials in the pediatric cancer population
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 .