Hesketh, P.J., Bosnjak, S.M., Nikolic, V., & Rapoport, B. (2011). Incidence of delayed nausea and vomiting in patients with colorectal cancer receiving irinotecan-based chemotherapy. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 19, 2063–2066.
To prospectively determine the frequency of delayed nausea and vomiting with irinotecan-based chemotherapy following day 1 prophylaxis with a 5-HT3 receptor antagonist and dexamethasone
All patients received irinotecan-based chemotherapy. All patients received a standard antiemetic regimen prior to chemotherapy consisting of dexamethasone (8 mg oral or IV) and a 5-HT3 receptor antagonist (8 mg IV or 24 mg oral ondansetron, 100 mg IV or oral dolasetron, and 1 mg IV or 2 mg oral granisetron) given immediately prior to the start of chemotherapy only. No routine antiemetics were prescribed after day one for prophylaxis or delayed emesis. Palonosetron was not permitted in this study. All patients received a prescription for rescue therapy, only to be used during the first 120 hours. Patients were monitored for 120 hours after the initiation of irinotecan by the study coordinator who called at timed intervals to assist patients in completing diaries. During this study, patients only were observed on their first cycle of the irinotecan-based chemotherapy.
The study was conducted at multiple outpatient settings through the St. Elizabeth’s Medical Center in Boston, MA; Holy Family Hospital in Methuen, MA; and the Institute for Radiology and Oncology of Serbia.
This was a prospective, observational study.
The results of the study showed efficacy in reducing or controlling delayed nausea and vomiting during the 24-hour period following administration of a camptothecin analogue, a moderately ematogenic antineoplastic agent, when dexamethasone and a 5-HT3 receptor antagonist was used as prophylaxis for acute chemotherapy-induced nausea and vomiting (CINV).
The use of dexamethasone and a 5-HT3 receptor antagonist prior to administration of a camptothecin analogue is recommended in the literature and has been shown to be beneficial in controlling acute CINV, which contributes in reducing delayed nausea and vomiting.