Abstract
The efficacy and safety of granisetron and ondansetron for the prophylaxis of nausea and vomiting resulting from hyperfractionated total body irradiation (TBI) were assessed. Thirty-four patients randomly received double-blind, oral granisetron (2 mg, 1 h before first daily fraction of radiation) or ondansetron (8 mg, 1.5 h prior to each fraction of TBI). Ninety patients who received the same TBI regimen prior to bone marrow transplantation (BMT), but no 5-HT3-receptor antagonist, were identified and comprised the historical control group. By design, this study was only powered to show a difference between each of the active treatment groups and the historical control group. Significantly more patients given granisetron (33.3%) or ondansetron (26.7%) had zero emetic episodes over 4 days, the primary efficacy end point, than those in the historical control group (0%) (P < 0.01; intent-to-treat). Secondary efficacy end points were also evaluated. during the first 24 h, significantly more patients taking granisetron (61.1%) or ondansetron (46.7%) had zero emetic episodes than patients in the historical control group (6.7%) (P < 0.01). Complete emetic control (no emesis or rescue antiemetic) over 4 days was more frequent in patients taking granisetron (27.8%) or ondansetron (26.7%) compared with the historical control group (0%) (P < 0.01). Significantly fewer patients taking granisetron (18/18), but not those taking ondansetron (12/15), experienced more than five emetic episodes during the 4 days of the study compared with the historical control group (40/90; P < 0.01). Oral granisetron and ondansetron are safe and effective for the prevention of nausea and vomiting resulting from TBI. Bone Marrow Transplantation (2000) 26, 203–210.
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References
Basara N, Blau WI, Kiehl MG et al. Efficacy and safety of mycophenolate mofetil for the treatment of acute and chronic GVHD in bone marrow transplant recipient Transplant Proc 1998 30: 4087–4089
Deeg HJ, Lin D, Leisenring W et al. Cyclosporine or cyclosporine plus methylprednisolone for prophylaxis of graft-versus-host disease: a prospective, randomized trial Blood 1997 89: 3880–3887
von Bueltzingsloewen A, Bordigoni P, Witz F et al. Prophylactic use of ganciclovir for allogeneic bone marrow transplant recipients Bone Marrow Transplant 1993 12: 197–202
Deeg HJ for the Seattle Marrow Transplant Team . Acute and delayed toxicities of total body irradiation Int J Radiat Oncol Biol Phys 1983 9: 1933–1939
Alfieri AB, Cubeddu LX . Treatment with para-chlorophenyl-alanine antagonizes the emetic response and the serotonin-releasing actions of cisplatin in cancer patients Br J Cancer 1995 71: 629–632
Miner WD, Sanger GJ, Turner DH . Evidence that 5-hydroxytryptamine3 receptors mediate cytotoxic drug and radiation-evoked emesis Br J Cancer 1987 56: 159–162
Sanger GJ . The pharmacology of antiemetic agents. In: Andrews PLR, Sanger GJ (eds) Emesis in Anti-cancer Therapy: Mechanisms and Treatment Chapman & Hall Medical: London 1993 pp179–210
Reynolds DJM . Where do 5-HT3 receptor antagonists act as anti-emetics? In: Reynolds DJM, Andrews PLR, Davis CJ (eds) Serotonin and the Scientific Basis of Anti-Emetic Therapy Oxford Clinical Communications: Oxford 1995 pp111–126
Spitzer TR . Clinical evidence for 5-HT3 receptor antagonist efficacy in radiation-induced emesis. In: Reynolds DJM, Andrews PLR, Davis CJ (eds) Serotonin and the Scientific Basis of Anti-Emetic Therapy Oxford Clinical Communications: Oxford 1995 pp134–141
Aapro MS, Plezia PM, Alberts DS et al. Double-blind crossover study of the antiemetic efficacy of high-dose dexamethasone versus high-dose metoclopramide J Clin Oncol 1984 2: 466–471
Hainsworth J, Harvey W, Pendergrass K et al. A single-blind comparison of intravenous ondansetron, a selective serotonin antagonist, with intravenous metoclopramide in the prevention of nausea and vomiting associated with high-dose cisplatin chemotherapy J Clin Oncol 1991 9: 721–728
Hewitt M, Cornish J, Pamphilon D, Oakhill A . Effective emetic control during conditioning of children for bone marrow transplantation using ondansetron, a 5-HT3 antagonist Bone Marrow Transplant 1991 7: 431–433
Kris MG, Cubeddu LX, Gralla RJ et al. Are more antiemetic trials with a placebo necessary? Report of patient data from randomized trials of placebo antiemetics with cisplatin Cancer 1996 78: 2193–2198
Kris MG, Gralla RJ, Clark RA et al. Antiemetic control and prevention of side-effects of anti-cancer therapy with lorazepam or diphenhydramine when used in combination with metoclopramide plus dexamethasone: a double-blind, randomized trial Cancer 1987 60: 2816–2822
Kris MG, Gralla RJ, Tyson LB et al. Improved control of cisplatin-induced emesis with high-dose metoclopramide and with combinations of metoclopramide, dexamethasone, and diphenhydramine: results of consecutive trials in 255 patients Cancer 1985 55: 527–534
Kris MG, Tyson LB, Gralla RJ et al. Extrapyramidal reactions with high-dose metoclopramide (letter) New Engl J Med 1983 309: 433–434
Sridhar KS, Donnelly E . Combination antiemetics for cisplatin chemotherapy Cancer 1988 61: 1508–1517
Bonneterre J, Chevallier B, Metz R et al. A randomized double-blind comparison of ondansetron and metoclopramide in the prophylaxis of emesis induced by cyclophosphamide, fluorouracil, and doxorubicin or epirubicin chemotherapy J Clin Oncol 1990 8: 1063–1069
Latreille J, Pater J, Johnston D et al . for the National Cancer Institute of Canada Clinical Trials Group Use of dexamethasone and granisetron in the control of delayed emesis for patients who receive highly emetogenic chemotherapy J Clin Oncol 1998 16: 1174–1178
Marty M, Pouillart P, Scholl S et al. Comparison of the 5-hydroxytryptamine3 (serotonin) antagonist ondansetron (GR 38032F) with high-dose metoclopramide in the control of cisplatin-induced emesis New Engl J Med 1990 322: 816–821
Navari RM, Kaplan HG, Gralla RJ et al. Efficacy and safety of granisetron, a selective 5-hydroxytryptamine-3 receptor antagonist, in the prevention of nausea and vomiting induced by high-dose cisplatin JClin Oncol 1994 12: 2204–2210
Spitzer TR, Bryson JC, Cirenza E et al. Randomized double-blind, placebo-controlled evaluation of oral ondansetron in the prevention of nausea and vomiting associated with fractionated total body irradiation J Clin Oncol 1994 12: 2432–2438
Gralla RJ, Itri LM, Pisko SE et al. Antiemetic efficacy of high-dose metoclopramide: randomized trials with placebo and prochlorperazine in patients with chemotherapy-induced nausea and vomiting New Engl J Med 1981 305: 905–909
Malik IA, Khan WA, Qazilbash M et al. Clinical efficacy of lorazepam in prophylaxis of anticipatory, acute, and delayed nausea and vomiting induced by high doses of cisplatin Am J Clin Oncol 1995 18: 170–175
Mercadante S . Nutrition in cancer patients Supp Care Cancer 1996 4: 10–20
Abbott B, Ippoliti C, Bruton J et al. Antiemetic efficacy of granisetron plus dexamethasone in bone marrow transplant patients receiving chemotherapy and total body irradiation Bone Marrow Transplant 1999 23: 265–269
Belkacémi Y, Ozsahin M, Pène F et al. Total body irradiation prior to bone marrow transplantation: efficacy and safety of granisetron in the prophylaxis and control of radiation-induced emesis Int J Radiat Oncol Biol Phys 1996 1: 77–82
Dagher R, Robertson KA, Lucas KG et al. Outpatient total body irradiation for pediatric patients undergoing stem cell transplantation Bone Marrow Transplant 1997 19: 1065–1067
Prentice HG, Cunningham S, Gandhi L et al. Granisetron in the prevention of irradiation-induced emesis Bone Marrow Transplant 1995 15: 445–448
Hunter AE, Prentice HG, Pothecary K et al. Granisetron,a selective 5-HT3 receptor antagonist, for the prevention ofradiation induced emesis during total body irradiation Bone Marrow Transplant 1991 7: 439–441
Okamoto S, Takahashi S, Tanosaki R et al. Granisetron in the prevention of vomiting induced by conditioning for stem cell transplantation: a prospective randomized study Bone Marrow Transplant 1996 17: 679–683
Stewart A, McQuade B, Cronje JDE et al. on behalf of the Emesis Study Group for ondansetron and granisetron in breast cancer patients Ondansetron compared with granisetron in the prophylaxis of cyclophosphamide-induced emesis in out-patients: a multicentre, double-blind, double-dummy, randomised, parallel-group study Oncology 1995 52: 202–210
Pocock SJ . Problems with historical controls. In: Pocock SJ (ed) Clinical Trials: A Practical Approach John Wiley: Chichester 1995 pp54–60
Holdsworth MT . Ethical issues regarding study designs used in serotonin-antagonist drug development Ann Pharmacother 1996 30: 1182–1184
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Spitzer, T., Friedman, C., Bushnell, W. et al. Double-blind, randomized, parallel-group study on the efficacy and safety of oral granisetron and oral ondansetron in the prophylaxis of nausea and vomiting in patients receiving hyperfractionated total body irradiation. Bone Marrow Transplant 26, 203–210 (2000). https://doi.org/10.1038/sj.bmt.1702479
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DOI: https://doi.org/10.1038/sj.bmt.1702479
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