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Update on the management of chemotherapy-induced nausea and vomiting – focus on palonosetron

PURPOSE: Nausea and vomiting are major adverse effects of chemotherapy and can greatly impact patients’ quality of life. Although chemotherapy-induced nausea and vomiting (CINV) prevalence is high, treatment remains difficult. Palonosetron is a 5-hydroxytryptamine receptor antagonist (5-HT(3)RA) app...

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Autores principales: Zhou, Michelle, Popovic, Marko, Pasetka, Mark, Pulenzas, Natalie, Ahrari, Soha, Chow, Edward, DeAngelis, Carlo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435088/
https://www.ncbi.nlm.nih.gov/pubmed/25999723
http://dx.doi.org/10.2147/TCRM.S68130
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author Zhou, Michelle
Popovic, Marko
Pasetka, Mark
Pulenzas, Natalie
Ahrari, Soha
Chow, Edward
DeAngelis, Carlo
author_facet Zhou, Michelle
Popovic, Marko
Pasetka, Mark
Pulenzas, Natalie
Ahrari, Soha
Chow, Edward
DeAngelis, Carlo
author_sort Zhou, Michelle
collection PubMed
description PURPOSE: Nausea and vomiting are major adverse effects of chemotherapy and can greatly impact patients’ quality of life. Although chemotherapy-induced nausea and vomiting (CINV) prevalence is high, treatment remains difficult. Palonosetron is a 5-hydroxytryptamine receptor antagonist (5-HT(3)RA) approved for treatment of CINV. The purpose of this review is to discuss existing and emerging therapeutic options, and examine studies focusing on palonosetron with regards to efficacy, pharmacology, tolerability, safety, and patient-derived outcomes. METHODS: A literature search was conducted using Ovid MEDLINE and EMBASE to identify relevant studies using palonosetron alone or in combination with other antiemetics. Studies were extracted if they included complete response (CR), complete control (CC), no nausea, no vomiting, and no rescue medications as an endpoint. Studies were also included if safety endpoints were examined. RESULTS: Palonosetron alone has been shown to improve CR and CC rates for patients receiving low, moderate, or high emetogenic chemotherapy. Rates were further improved with the addition of dexamethasone, a corticosteroid. Furthermore, the addition of neurokinin-1 receptor antagonists, such as netupitant markedly improved efficacy profiles compared to palonosetron alone. Aprepitant is an antiemetic that has exhibited positive results in combination with palonosetron. Recently, a new drug consisting of netupitant and palonosetron (NEPA) has demonstrated significantly more efficacious prevention of CINV. Regardless of the combination, palonosetron has been well tolerated. The most common adverse events were constipation, headache, fatigue, and dizziness, with the majority of patients describing them as only mild or moderate. CONCLUSION: Palonosetron, alone or with other antiemetics, has improved CINV treatment due to its ability to significantly reduce delayed phases of CINV, compared to similar 5-HT(3)RAs. Palonosetron is both more effective than first generation 5-HT(3)RAs and safer, as it results in a smaller prolongation of the QTc interval, compared to other 5-HT(3)RAs.
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spelling pubmed-44350882015-05-21 Update on the management of chemotherapy-induced nausea and vomiting – focus on palonosetron Zhou, Michelle Popovic, Marko Pasetka, Mark Pulenzas, Natalie Ahrari, Soha Chow, Edward DeAngelis, Carlo Ther Clin Risk Manag Review PURPOSE: Nausea and vomiting are major adverse effects of chemotherapy and can greatly impact patients’ quality of life. Although chemotherapy-induced nausea and vomiting (CINV) prevalence is high, treatment remains difficult. Palonosetron is a 5-hydroxytryptamine receptor antagonist (5-HT(3)RA) approved for treatment of CINV. The purpose of this review is to discuss existing and emerging therapeutic options, and examine studies focusing on palonosetron with regards to efficacy, pharmacology, tolerability, safety, and patient-derived outcomes. METHODS: A literature search was conducted using Ovid MEDLINE and EMBASE to identify relevant studies using palonosetron alone or in combination with other antiemetics. Studies were extracted if they included complete response (CR), complete control (CC), no nausea, no vomiting, and no rescue medications as an endpoint. Studies were also included if safety endpoints were examined. RESULTS: Palonosetron alone has been shown to improve CR and CC rates for patients receiving low, moderate, or high emetogenic chemotherapy. Rates were further improved with the addition of dexamethasone, a corticosteroid. Furthermore, the addition of neurokinin-1 receptor antagonists, such as netupitant markedly improved efficacy profiles compared to palonosetron alone. Aprepitant is an antiemetic that has exhibited positive results in combination with palonosetron. Recently, a new drug consisting of netupitant and palonosetron (NEPA) has demonstrated significantly more efficacious prevention of CINV. Regardless of the combination, palonosetron has been well tolerated. The most common adverse events were constipation, headache, fatigue, and dizziness, with the majority of patients describing them as only mild or moderate. CONCLUSION: Palonosetron, alone or with other antiemetics, has improved CINV treatment due to its ability to significantly reduce delayed phases of CINV, compared to similar 5-HT(3)RAs. Palonosetron is both more effective than first generation 5-HT(3)RAs and safer, as it results in a smaller prolongation of the QTc interval, compared to other 5-HT(3)RAs. Dove Medical Press 2015-05-05 /pmc/articles/PMC4435088/ /pubmed/25999723 http://dx.doi.org/10.2147/TCRM.S68130 Text en © 2015 Zhou et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Zhou, Michelle
Popovic, Marko
Pasetka, Mark
Pulenzas, Natalie
Ahrari, Soha
Chow, Edward
DeAngelis, Carlo
Update on the management of chemotherapy-induced nausea and vomiting – focus on palonosetron
title Update on the management of chemotherapy-induced nausea and vomiting – focus on palonosetron
title_full Update on the management of chemotherapy-induced nausea and vomiting – focus on palonosetron
title_fullStr Update on the management of chemotherapy-induced nausea and vomiting – focus on palonosetron
title_full_unstemmed Update on the management of chemotherapy-induced nausea and vomiting – focus on palonosetron
title_short Update on the management of chemotherapy-induced nausea and vomiting – focus on palonosetron
title_sort update on the management of chemotherapy-induced nausea and vomiting – focus on palonosetron
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435088/
https://www.ncbi.nlm.nih.gov/pubmed/25999723
http://dx.doi.org/10.2147/TCRM.S68130
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