Brugnatelli, S., Gattoni, E., Grasso, D., Rossetti, F., Perrone, T., & Danova, M. (2011). Single-dose palonosetron and dexamethasone in preventing nausea and vomiting induced by moderately emetogenic chemotherapy in breast and colorectal cancer patients. Tumori, 97(3), 362–366.
To evaluate the efficacy and safety of palonosetron followed by dexamethasone administered as a single dose for the prevention of vomiting and nausea in patients receiving moderately emetogenic chemotherapy for breast and colorectal cancer
A bolus dose of 0.25 mg IV palonosetron was given over 30 seconds beginning 30 minutes before chemotherapy, followed by 8 mg IV dexamethasone. Patients were asked to complete diaries to assess antiemetic response during the acute, delayed, and overall phases (days 1–5).
This study was conducted at a single outpatient site in Cinisello Balsamo, Italy.
This was a phase II, open label, nonrandomized prospective study.
Palonosetron followed by dexamethasone in a single administration before chemotherapy to patients with breast or colorectal cancer provides significant protection during the overall phases of chemotherapy. Patients reported high satisfaction with this regimen.
Palonosetron followed by dexamethasone should be considered as premedication on day 1 in moderately emetogenic chemotherapy regimens in patients with breast or colorectal cancer.
Although a complete response was observed in 67% of patients, 33% did not experience complete response. Despite this, the authors stated that this medication regimen adequately controlled CINV during the entire period of emetic risk. Additionally, the 33% of nonresponders does not include high-risk patients who were excluded from this study because of a history of previous nausea and vomiting.
The key takeaway for nurses is that a significant number of patients may require both pharmacologic and nonpharmacologic strategies to help them through this time.