Management of Chemotherapy Induced Nausea and Vomiting in Patients on Multiday Cisplatin Based Combination Chemotherapy

Table 1

Selected phases II and III trials of various agents for treatment of chemotherapy induced nausea and vomiting in patients undergoing multiday cisplatin based chemotherapy.

Study	Phase		CINV prophylaxis	Emesis		Nausea
				Day 1 CR	Days 1–5 CR
Einhorn et al., 1990 [14]	II	36	Ondansetron	77%	30%	NA
Sledge et al., 1992 [15]	III	45	Ondansetron versus metoclopramide	78% versus 14% ( < 0.001)	30% versus 9% ()	VAS scores 8 versus 58.5 ( < 0.001)
Bremer, 1992 [17]	III	200	Granisetron versus alizapride (substituted benzamide) + dexamethasone	90% versus 66% ( < 0.001)	49% versus 35%.	NA
Fox et al., 1993 [21]	III	45	Ondansetron + dexamethasone + chlorpromazine versus ondansetron	95% versus 82%	55% versus 32% ()	VAS scores 5.5 versus 15 (p = 0.046)
Noble et al., 1994 [18]	III	200	Ondansetron versus granisetron	NA	40% versus 44% Patient preference, 34% versus 26% ( = 0.048)	NA
Fauser et al., 2000 [22]	III	210	Dolasetron + dexamethasone versus dolasetron	NA	73% versus 41% ( < 0.0001). CR rates on each study day were also significantly higher ( = 0.029)	VAS score of 0 (no nausea) day 1: 88% versus 60% ( < 0.001); day 5: 63% versus 37% ( = 0.017)
Einhorn et al., 2007 [23]	II	41	Palonosetron + dexamethasone	88%	51%	No or mild nausea, self-reported 59%
Albany et al., 2012 [24]	III	69	Aprepitant + 5-HT3 RA (other than palonosetron) + dexamethasone versus aprepitant + dexamethasone	NA	47% versus 15% ()	VAS: aprepitant better than placebo on all 6 days
Hamada et al., 2014 [25]	II	30	Aprepitant + palonosetron + dexamethasone	NA	90%	Mild to no nausea 70%

CR: complete response (no emesis and no need for rescue medication); VAS: visual analog scale for nausea; 5-HT₃ RA: 5-hydroxytryptamine receptor antagonists; NA: not available.