scholarly journals Palonosetron exhibits higher total control rate compared to first-generation serotonin antagonists and improves appetite in delayed-phase chemotherapy-induced nausea and vomiting

2014 ◽  
Vol 2 (3) ◽  
pp. 375-379 ◽  
Author(s):  
HIROKI UEDA ◽  
CHIGUSA SHIMONO ◽  
TOMOYASU NISHIMURA ◽  
MEGUMI SHIMAMOTO ◽  
HIROKI YAMAUE
Keyword(s):  
First Generation ◽  
Nausea And Vomiting ◽  
Serotonin Antagonists ◽  
Total Control ◽  
Delayed Phase

scholarly journals Efficacy and safety of 5 mg olanzapine for nausea and vomiting management in cancer patients receiving carboplatin: integrated study of three prospective multicenter phase II trials

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Senri Yamamoto ◽  
Hirotoshi Iihara ◽  
Ryuji Uozumi ◽  
Hitoshi Kawazoe ◽  
Kazuki Tanaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cancer Patients ◽  
Phase Ii ◽  
Low Dose ◽  
Nausea And Vomiting ◽  
Efficacy And Safety ◽  
Multivariable Logistic Regression ◽  
Related Risk ◽  
Total Control

Abstract Background The efficacy of olanzapine as an antiemetic agent in cancer chemotherapy has been demonstrated. However, few high-quality reports are available on the evaluation of olanzapine’s efficacy and safety at a low dose of 5 mg among patients treated with carboplatin regimens. Therefore, in this study, we investigated the efficacy and safety of 5 mg olanzapine for managing nausea and vomiting in cancer patients receiving carboplatin regimens and identified patient-related risk factors for carboplatin regimen-induced nausea and vomiting treated with 5 mg olanzapine. Methods Data were pooled for 140 patients from three multicenter, prospective, single-arm, open-label phase II studies evaluating the efficacy and safety of olanzapine for managing nausea and vomiting induced by carboplatin-based chemotherapy. Multivariable logistic regression analyses were performed to determine the patient-related risk factors. Results Regarding the endpoints of carboplatin regimen-induced nausea and vomiting control, the complete response, complete control, and total control rates during the overall study period were 87.9, 86.4, and 72.9%, respectively. No treatment-related adverse events of grade 3 or higher were observed. The multivariable logistic regression models revealed that only younger age was significantly associated with an increased risk of non-total control. Surprisingly, there was no significant difference in CINV control between the patients treated with or without neurokinin-1 receptor antagonist. Conclusions The findings suggest that antiemetic regimens containing low-dose (5 mg) olanzapine could be effective and safe for patients receiving carboplatin-based chemotherapy.

scholarly journals Light element discontinuities suggest an early termination of star formation in the globular cluster NGC 6402 (M14)

2019 ◽  
Vol 485 (3) ◽  
pp. 4311-4329 ◽  
Author(s):  
Christian I Johnson ◽  
Nelson Caldwell ◽  
R Michael Rich ◽  
Mario Mateo ◽  
John I Bailey
Keyword(s):  
Globular Clusters ◽  
First Generation ◽  
Light Element ◽  
Chemical Abundances ◽  
Intermediate Composition ◽  
Chemical Enrichment ◽  
The Galaxy ◽  
Red Giant ◽  
Composition Properties ◽  
Delayed Phase

ABSTRACT NGC 6402 is among the most massive globular clusters in the Galaxy, but little is known about its detailed chemical composition. Therefore, we obtained radial velocities and/or chemical abundances of 11 elements for 41 red giant branch stars using high resolution spectra obtained with the Magellan-M2FS instrument. We find NGC 6402 to be only moderately metal-poor with 〈[Fe/H]〉 = −1.13 dex (σ = 0.05 dex) and to have a mean heliocentric radial velocity of −61.1 km s−1 (σ = 8.5 km s−1). In general, NGC 6402 exhibits mean composition properties that are similar to other inner Galaxy clusters, such as [α/Fe] ∼+0.3 dex, [Cr,Ni/Fe] ∼ 0.0 dex, and 〈[La/Eu]〉 = −0.08 dex. Similarly, we find large star-to-star abundance variations for O, Na, Mg, Al, and Si that are indicative of gas that experienced high temperature proton-capture burning. Interestingly, we not only detect three distinct populations but also find large gaps in the [O/Fe], [Na/Fe], and [Al/Fe] distributions that may provide the first direct evidence of delayed formation for intermediate composition stars. A qualitative enrichment model is discussed where clusters form stars through an early ($\lesssim$5–10 Myr) phase, which results in first generation and ‘extreme’ composition stars, and a delayed phase ($\gtrsim$40 Myr), which results in the dilution of processed and pristine gas and the formation of intermediate composition stars. For NGC 6402, the missing intermediate composition stars suggest the delayed phase terminated prematurely, and as a result the cluster may uniquely preserve details of the chemical enrichment process.

Palonostron with aprepitant plus dexamethasone to prevent chemotherapy-induced nausea and vomiting (CINV) during gemcitabine/cisplatin (GC) in urothelial cancer (UC) patients: A multi-institutional retrospective study in Japan.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 362-362
Author(s):  
Hiroshi Kitamura ◽  
Atsushi Takahashi ◽  
Hiroshi Hotta ◽  
Ryuichi Kato ◽  
Yasuharu Kunishima ◽  
...  
Keyword(s):  
First Generation ◽  
Urothelial Cancer ◽  
Rescue Therapy ◽  
Nausea And Vomiting ◽  
Lower Grade ◽  
Receptor Antagonists ◽  
Standard Regimen ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

362 Background: GC combination chemotherapy of is a standard regimen for advanced UC. Although this is a highly emetogenic chemotherapy, there has been no study concerning antiemetic prophylaxis for CINV during GC. The aims of this study were to evaluate CINV during GC and to compare the antiemetic efficacy of the triple combination of palonosetron, aprepitant and dexamethasone with that of our old regimen using first-generation 5-HT3 receptor antagonists and dexamethasone. Methods: We conducted a retrospective multi-institutional review of the medical records of 122 patients who received GC for advanced urothelial cancer between February 2005 and January 2012. Uncontrolled CINV events were identified through records of nausea and vomiting, additional infusion, rescue medications, and/or records of food intake. Nausea, vomiting, and anorexia were classified using the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Results: A total of 75 and 47 patients were treated with first-generation 5-HT3 receptor antagonists (ondansetron or granisetron) plus dexamethasone (group 1) and palonosetron with dexamethasone plus aprepitant (group 2), respectively. There was no significant difference in age, sex, or the dose of cisplatin between the 2 groups. Patients in group 2 had significantly higher CR (defined as no emetic episodes and no rescue medication use) rates than those in group 1 during the overall phase in the first cycle (85.7% versus 65.3%, p=0.012) and all cycles (78.7% versus 50.7%, p=0.0019) of GC. Patients in group 2 were more likely to achieve more favorable CINV control, e.g., a lower grade of nausea, vomiting, or anorexia, lower incidence of rescue therapy required, and shorter time to become CINV-free, than patients in group 1. Conclusions: This study shows that palonosetron in combination with aprepitant and dexamethasone is more effective to prevent chemotherapy-induced nausea and vomiting in UC patients treated with GC than first-generation 5-HT3 receptor antagonists plus dexamethasone.

scholarly journals Comparasion of granisetron and metoclopramide for prevention of nausea and vomiting following total cystectomy and ileal conduit

2007 ◽  
Vol 54 (2) ◽  
pp. 19-22
Author(s):  
N. Ladjevic ◽  
I. Likic-Ladjevic ◽  
B. Krivic ◽  
J. Filimonovic ◽  
M. Acimovic ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Postoperative Period ◽  
Low Dose ◽  
Ileal Conduit ◽  
Early Postoperative Period ◽  
Nausea And Vomiting ◽  
Actual Clinical Practice ◽  
Total Cystectomy ◽  
Total Control

The objective of this study was to examine the use of granisetron in actual clinical practice and to compare effect of dose of 1 mg granisetron after total cystectomy plus ileal conduit with group of patients which received metoclopramide. Granisetron established total control of PONV in 93,33% patients. Granisetron is 40% more effective in PONV control than metoclopramide. Only minimal nausea episodes were observed in early postoperative period in patients who had received low dose of granisetron (1 mg i.v.). .

Aprepitant in multiple-day cisplatin-based chemotherapy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19591-e19591
Author(s):  
Johann-Francois Ouellette Freve ◽  
Denis Soulieres ◽  
Normand Blais ◽  
Nathalie LeTarte
Keyword(s):  
Adverse Events ◽  
Medical Records ◽  
Standard Treatment ◽  
Complete Response ◽  
Primary Prophylaxis ◽  
Small Population ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Serotonin Antagonists ◽  
Moderately Emetogenic Chemotherapy

e19591 Background: Aprepitant is a NK-1 inhibitor approved in combination with serotonin antagonists and dexamethasone (Dex) for highly and moderately emetogenic chemotherapy. Antiemetic regimens for multiple-day chemotherapy are not standard and guidelines recommend serotonin antagonists and Dex for each day of chemotherapy and for following days. Studies with aprepitant in that setting are ongoing. In our center, aprepitant use with multiple-day chemotherapy was prescribed at the physician’s discretion. Methods: We did a retrospective study of the use of aprepitant with cisplatin-based multiple-day chemotherapy (CBMDC) regimens from November 2008 to November 2011. Pharmacy files were used to identify patients that received at least one dose of CBMDC. Data was extracted from pharmacy and medical records. Objectives included efficacy (complete response (CR), absence of nausea and vomiting, change in antiemetics) and safety of different regimens. Results: During the study period, 39 patients (34 men) received CBMDC, mostly BEP for testicular cancer. Three patients also received second-line treatment. Patients received BEP (93%), ICE (2%), or TIP (5%) chemotherapy. Eleven patients received 3-day aprepitant, 15 patients 5-day aprepitant and 16 patients did not receive aprepitant at all as primary prophylaxis. Patients were older in the 3-day group. CR was 1% in the 3 day-group, 64% in the 5-day group and 36% in the control group (p=0,08). There was a trend that nausea and vomiting were reported more frequently in the 3-day group. In 4 patients, aprepitant was added for days 4 and 5 in subsequent cycles with better control. Rescue medication was used in 100% of patients receiving the 3-day regimen, 36% in patients receiving the 5-day regimen and 64% of patients not receiving aprepitant. Three patients receiving 5-day aprepitant had to further decrease their Dex dose for adverse events (insomnia, emotional lability, pyrosis, acne). No severe adverse events were reported with the 5-day use of aprepitant. Conclusions: Even within a small population, five-day aprepitant is effective in inducing CR, reducing vomiting and is safe in patients receiving CBMDC. It has been chosen as a standard treatment in our patients.

Nausea and vomiting during high-dose interleukin-2 (HD IL-2) therapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20661-e20661
Author(s):  
Mark Fesler ◽  
Melinda Bernabe Chu ◽  
Eric Armbrecht ◽  
Scott Fosko ◽  
Eddy C. Hsueh ◽  
...  
Keyword(s):  
Acute Phase ◽  
Drug Targets ◽  
Rescue Medication ◽  
Rescue Therapy ◽  
Interleukin 2 ◽  
Retrospective Chart Review ◽  
Nausea And Vomiting ◽  
High Dose ◽  
Saint Louis ◽  
Delayed Phase

e20661 Background: Nausea and vomiting (N/V) are two common side effects during HD IL-2 therapy. They may be severe enough to cause electrolyte imbalances or lead to missed doses, which may compromise response. Our aim was to describe the incidence of N/V during HD IL-2 therapy at our institution. Methods: A retrospective chart review of patients treated with HD IL-2 therapy (720,000 IU/kg per dose intravenously; 14 doses, 2 cycles per course, maximum 2 courses) from January 1999 to June 2011 at Saint Louis University was performed. Patients received scheduled PO ondansetron 24 mg daily and prochlorperazine 10 mg IV or PO every 4 hours as needed per standard protocol. Additional antiemetics were ordered at the clinician’s discretion. Data regarding incidence of N/V and use and type of rescue medication for N/V were recorded. Results: 104 patients were identified (68 melanoma and 36 renal cell carcinoma). Median age was 53.7 years (17.7-77.7 years) and there were 66 men and 38 women. Only 3.8% of patients (4 out of 104) were able to complete HD IL-2 therapy without rescue medication. All patients (n = 100) who needed rescue therapy received prochlorperazine on day 1 of treatment (acute phase) and at least 1 additional day during days 2-6 of each admission (delayed phase). Metoclopramide (n = 23) was the most common supplemental antiemetic ordered followed by promethazine (n = 16), meclizine (n = 5), and palonsetron (n = 3). Conclusions: Almost all patients who underwent HD IL-2 therapy had N/V that necessitated rescue therapy during both the acute phase and the delayed phase. Decreasing the incidence and severity of N/V may increase patients’ quality of life during this demanding regimen. Current protocols are single-institution based, but generally include daily 5HT-3 antagonists and prochlorperazine as needed. Our data suggests that this regimen is inadequate. One challenge to management is that steroids, which are commonly used as adjuncts, are contraindicated during immunotherapy. Additional therapeutic options are still needed. Recently new drug targets, including neurokinin-1 receptor (NK1R) inhibitors, have been approved to treat N/V during chemotherapy. NK1R inhibitors may be of assistance during immunotherapy with HD IL-2 in the future.

Comparison of intermittent versus continuous infusion metoclopramide in control of acute nausea induced by cisplatin chemotherapy.

1989 ◽  
Vol 7 (7) ◽  
pp. 943-946 ◽  
Author(s):  
R M Navari
Keyword(s):  
Lung Cancer ◽  
Continuous Infusion ◽  
Small Cell ◽  
Nausea And Vomiting ◽  
Poor Control ◽  
Acute Nausea ◽  
Total Control ◽  
Chemotherapy Patients ◽  
Advanced Stage Lung Cancer ◽  
Stage Lung Cancer

Sixty previously untreated patients with newly diagnosed advanced-stage lung cancer (21 small-cell, 39 non-small-cell) received chemotherapy with cisplatin and etoposide. Bleomycin was also used in the patients with non-small-cell lung cancer. During the first cycle of chemotherapy, 30 patients received antiemetic therapy with intermittent metoclopramide (regimen A), and the other 30 patients received continuous infusion metoclopramide (regimen B). During the second course of chemotherapy, patients were switched to the alternate regimen. Regimen A consisted of lorazepam, 1 mg, orally; dexamethasone, 10 mg, intravenously (IV) every four hours for three doses; diphenhydramine, 0.5 mg/kg, IV every four hours for three doses; metoclopramide, 1 mg/kg, IV bolus every two hours for six doses. Regimen B was identical to A except metoclopramide was administered as 1 mg/kg, IV bolus followed by 0.5 mg/kg/h for ten hours. Fifty-eight patients completed both antiemetic regimens. Thirty-nine of the 58 patients had total control of acute nausea and vomiting (0-1 episodes) with regimen A or B. Fourteen patients had poor control of acute nausea and vomiting (more than one episode) with regimen A but total control with regimen B. Five patients had poor control with either regimen. Dystonic reactions, akathisia, or diarrhea occurred in 20 of the 58 patients on regimen A, but in only eight of the 58 patients on regimen B. Compared with intermittent bolus, continuous infusion metoclopramide is more effective in total control of acute nausea and vomiting and has less toxicity.

scholarly journals Antiemetic Prophylaxis with NEPA (NETUPITANT/PALONOSETRON) and Dexamethasone to Prevent Chemotherapy-Induced Nausea and Vomiting (CINV) in Hodgkin'S Lymphoma Naïve Patients Receiving ABVD Regimen: A Multicenter Phase Iia Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 18-18
Author(s):  
Daniela Nasso ◽  
Silvia Bolis ◽  
Elisabetta Abruzzese ◽  
Ilaria Romano ◽  
Caterina Patti ◽  
...  
Keyword(s):  
Receptor Antagonist ◽  
Board Of Directors ◽  
Acute Phase ◽  
Primary Endpoint ◽  
Hodgkin’S Lymphoma ◽  
Nausea And Vomiting ◽  
Hodgkin's Lymphoma ◽  
Electrolyte Imbalance ◽  
Advisory Committees ◽  
Delayed Phase

Cancer chemotherapy may be associated with a high incidence of nausea and vomiting, particularly when highly emetogenic antineoplastic drugs are used. Uncontrolled emesis can profoundly impact on the patient's quality of life and ability to survive, by causing dehydration, electrolyte imbalance, malnutrition and treatment discontinuation. The ABVD regimen (Adriamycin, Bleomycin, Vinblastine and Dacarbazine) is considered the standard of care for first-line treatment of Hodgkin's Lymphoma. Among these drugs, dacarbazine and adriamycin are the most emetogenic, being classified as highly and moderately emetogenic chemotherapy, respectively. NEPA is the first fixed antiemetic combination composed by the pharmacologically and clinically distinct 5HT3 receptor antagonist (5HT3-RA) palonosetron and the highly selective Neurokinin1/Substance P receptor antagonist (NK1-RA). A single dose of NEPA per chemotherapy cycle acts on the principal pathways involved in the mechanisms controlling nausea and vomiting in a synergistic way with an appropriate half-life to cover both the acute (0-24 hours from chemotherapy) and delayed (25-120 hours) phase. In this open label multicenter study, chemo-naïve Hodgkin's Lymphoma patients who were addressed to receive their first cycle of ABVD regimen (2 doses in 28 days, on days 1 and 15) were given a single administration of NEPA plus 4 mg dexamethasone. The primary endpoint was complete response (CR), defined as no emesis and no rescue medication during the overall phase (0-120 hours) on the first dose of the first ABVD cycle. A total of 77 patients were evaluated. According to the adopted Fleming one-stage design, the primary endpoint of this study was achieved. Indeed, the number of the complete responders for the overall phase among the first 70 consecutive patients was 66, which is greater than the pre-determined cut-off of 46, representing the minimum frequency of responders for which the treatment is considered effective. In addition to the primary efficacy endpoint, several additional endpoints were evaluated. The CR values were 93.5% for the acute phase, 81.8% for the delayed phase and 80.5% for the overall phase, while Complete Control (CR with no more than mild nausea) were achieved in the 93.5%of patients in the acute phase, 76.6% in the delayed phase and 75.3% in the overall phase (Figure 1A). Also, levels of no significant nausea (no more than mild nausea) were 94.6% for the acute phase, 83.1% for the delayed phase and 81.8% for the overall phase (Figure 1B). This study demonstrated the efficacy of NEPA plus dexamethasone in preventing the nausea and vomiting induced by the highly emetogenic ABVD regimen. Disclosures Abruzzese: Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees; Incyte: Consultancy, Membership on an entity's Board of Directors or advisory committees; Bms: Honoraria; Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees. Di Renzo:BerGenBio ASA: Research Funding. Flenghi:takeda: Consultancy; Roche: Consultancy; janssen-cilag: Consultancy; teva: Consultancy; Servier Italia: Consultancy. Cantonetti:Vifor: Consultancy; Mundipharma: Consultancy; Roche: Consultancy; Takeda: Consultancy.

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