Schwartzberg, L., Barbour, S.Y., Morrow, G.R., Ballinari, G., Thorn, M.D., & Cox, D. (2013). Pooled analysis of phase III clinical studies of palonosetron versus ondansetron, dolasetron, and granisetron in the prevention of chemotherapy-induced nausea and vomiting (CINV). Supportive Care in Cancer, 22(2), 469–477.
To determine the safety and efficacy of palonosetron versus older 5-HT3 receptor antagonists in the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately emetogenic chemotherapy (MEC) or highly emetogenic chemotherapy (HEC)
CR rates were significantly higher for patients who received palonosetron during the delayed (p < 0.0001) and overall (p < 0.0001) phases. There was a greater likelihood for patients who received palonosetron to achieve a CR in the delayed (OR, 1.62 [1.40–1.88]) and overall (OR, 1.56 [1.34–1.81]) phases. CC rates were significantly higher in patients who received palonosetron in the delayed (p < 0.0001) and overall (p < 0.001) phases. No differences in CR or CC were seen between groups in the acute phase. There was a significant difference in the number of emetic episodes in patients who received palonosetron in the acute (p = 0.007), delayed (p < 0.0001), and overall (p < 0.0001) phases. Significant differences were seen in the severity of nausea in the delayed (p = 0.0002) and overall (p = 0.011) phases.
Palonosetron is more effective at achieving CR and CC for CINV in the delayed and overall phases when compared to older 5-HT3 receptor antagonists. Palonosetron is also more effective at reducing the severity of nausea experienced in the delayed and overall phases after chemotherapy. However, in the acute phase, palonosetron is not more effective at controlling CINV compared to older 5-HT3 receptor antagonists.
For patients receiving MEC or HEC, the use of palonosetron rather than an older 5-HT3 receptor antagonist is more effective at controlling CINV in the delayed and overall phase after chemotherapy.