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Supportive Care in Cancer
Published in: Supportive Care in Cancer 9/2007

01-09-2007 | Review Article

A meta-analysis comparing the efficacy of four 5-HT3-receptor antagonists for acute chemotherapy-induced emesis

Authors: K. Jordan, A. Hinke, A. Grothey, W. Voigt, D. Arnold, H.-H. Wolf, H.-J. Schmoll

Published in: Supportive Care in Cancer | Issue 9/2007

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Abstract

Goals of work

Comparing antiemetic efficacy of different 5-HT3-receptor antagonists (5-HT3RAs) is difficult due to inter-study variability. Therefore, a meta-analysis was performed to comparatively evaluate dolasetron, granisetron, ondansetron and tropisetron for acute chemotherapy-induced nausea and vomiting (CINV).

Patients and methods

Comparisons between 5-HT3RAs were based on 44 randomized studies (including 12,343 patients) identified by MEDLINE, CANCERLIT or EMBASE searches and subcategorized by chemotherapy type (cisplatin- or non-cisplatin-based).

Main results

When all studies were combined, granisetron was equivalent to ondansetron (n = 27), and showed an advantage vs tropisetron (p = 0.018; n = 12). Ondansetron vs tropisetron (n = 11) and ondansetron vs dolasetron (n = 3) revealed equivalence in each comparison. An advantage for 3 mg granisetron vs 8 mg ondansetron was found in non-cisplatin-based studies (p = 0.015; n = 6). Overall equivalence was seen between ondansetron, 24 or 32 mg, and granisetron, 2 or 3 mg, for all studies (n = 13). There was a possible advantage for higher (24 or 32 mg) vs lower (8 mg) ondansetron dose regimens with cisplatin-based trials (n = 6). No differences were seen between 3 and 1 mg granisetron doses (n = 6).

Conclusions

Efficacy of 5-HT3RAs for preventing CINV following cisplatin- and non-cisplatin-based chemotherapy is comparable, with the exception of granisetron vs tropisetron. Some differences were noted in dosing subanalyses.
Literature
1.
Aapro M, Grunberg S, Manikhas G et al (2006) A phase III, double-blind, randomized trial of palonosetron compared with ondansetron in preventing chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy. Ann Oncol 17:1441–1449PubMedCrossRef
2.
Aksoylar S, Akman S, Ozgenc F et al (2001) Comparison of tropisetron and granisetron in the control of nausea and vomiting in children receiving combined cancer chemotherapy. Pediatr Hematol Oncol 18:397–406PubMedCrossRef
3.
Audhuy B, Cappelaere P, Martin M et al (1996) A double-blind, randomised comparison of the anti-emetic efficacy of two intravenous doses of dolasetron mesilate and granisetron in patients receiving high dose cisplatin chemotherapy. Eur J Cancer 32A:807–813PubMed
4.
Barrajon E, de las Penas R (2000) Randomised double blind crossover study comparing ondansetron, granisetron and tropisetron. A cost–benefit analysis. Support Care Cancer 8:323–333PubMedCrossRef
5.
Barrajon E, Gasent J (2000) A meta analysis of randomized trials evaluating ondansetron (O), granisetron (G) and tropisetron (T). Proc ASCO 2000 Annual Meeting; (Abstr 2415)
6.
Beck T, Hesketh P, Madajewicz S et al (1992) Stratified, randomized, double-blind comparison of intravenous ondansetron administered as a multiple-dose regimen versus two single-dose regimens in the prevention of cisplatin-induced nausea and vomiting. J Clin Oncol 10:1969–1975PubMed
7.
Bonneterre J, Hecquet B (1995) Granisetron (IV) compared with ondansetron (IV plus oral) in the prevention of nausea and vomiting induced by moderately-emetogenic chemotherapy. A cross-over study. Bull Cancer (Paris) 82:1038–1043
8.
Bosnjak S, Neskovic-Konstantinovic Z, Jovanovic-Micic D et al (1996) Single 8 mg dose of oral ondansetron failed to prevent FAC chemotherapy-induced acute nausea and vomiting. J Chemother 8:315–318PubMed
9.
Bubalo J, Seelig F, Karbowicz S et al (2001) Randomized open-label trial of dolasetron for the control of nausea and vomiting associated with high-dose chemotherapy with hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 7:439–445PubMedCrossRef
10.
Chiou T-J, Tzeng W-F, Wang S-S et al (2000) Comparison of the efficacy and safety of oral granisetron plus dexamethasone with intravenous ondansetron plus dexamethasone to control nausea and vomiting induced by moderate/severe emetogenic chemotherapy. Chin Med J 63:729–736
11.
Chua D, Sham J, Kwong D et al (2000) Comparative efficacy of three 5-HT3 antagonists (granisetron, ondansetron, and tropisetron) plus dexamethasone for the prevention of cisplatin-induced acute emesis. Am J Clin Oncol 23:185–191PubMedCrossRef
12.
de Wit R, de Boer A, Linden V et al (2001) Effective cross-over to granisetron after failure to ondansetron, a randomized double blind study in patients failing ondansetron plus dexamethasone during the first 24 hours following highly emetogenic chemotherapy. Br J Cancer 85:1099–1101PubMedCrossRef
13.
del Giglio A, Soares H, Caparroz C et al (2000) Granisetron is equivalent to ondansetron for prophylaxis of chemotherapy-induced nausea and vomiting: results of a meta-analysis of randomised controlled trials. Cancer 89:2301–2308PubMedCrossRef
14.
Dempsey CL, Coop AJ, Shillington A et al (2004) Antiemetic effectiveness of ondansetron and granisetron in patients with breast cancer treated with cyclophosphamide. Am J Health-Syst Pharm 61:781–786PubMed
15.
Doherty K (1999) Closing the gap in prophylactic antiemetic therapy: patient factors in calculating the emetogenic potential of chemotherapy. Clin J Oncol Nurs 3:113–119PubMed
16.
du Bois A (1998) Management der chemotherapie-induzierten Emesis: was ist standard nach 20 Jahren klinischer Forschung? Med Klin 93:3–17CrossRef
17.
Eisenberg P, Figueroa-Vadillo J, Zamora R et al (2003) Improved prevention of moderately emetogenic chemotherapy-induced nausea and vomiting with palonosetron, a pharmacologically novel 5-HT3 receptor antagonist: results of a phase III, single-dose trial versus dolasetron. Cancer 98:2473–2482CrossRef
18.
Fauser A, Duclos B, Chemaissani A et al (1996) Therapeutic equivalence of single oral doses of dolasetron mesilate and multiple doses of ondansetron for the prevention of emesis after moderately emetogenic chemotherapy. Eur J Cancer 9:1523–1529CrossRef
19.
Forni C, Ferrari S, Loro L et al (2000) Granisetron, tropisetron, and ondansetron in the prevention of acute emesis induced by a combination of cisplatin–Adriamycin and by high-dose ifosfamide delivered in mulitple-day continuous infusions. Support Care Cancer 8:131–133PubMedCrossRef
20.
Gebbia V, Cannata G, Testa A et al (1994) Ondansetron versus granisetron in the prevention of chemotherapy-induced nausea and vomiting. Cancer 74:1945–1552CrossRef
21.
Gralla R, Lichinitser M, Van Der Vegt S et al (2003) Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with ondansetron. Ann Oncol 14:1570–1577PubMedCrossRef
22.
Gralla R, Navari R, Hesketh P et al (1998) Single-dose oral granisetron has equivalent antiemetic efficacy to intravenous ondansetron for highly emetogenic cisplatin-based chemotherapy. J Clin Oncol 16:1568–1573PubMed
23.
Herrington J, Kwan P, Young R et al (2000) Randomized, multicenter comparison of oral granisetron and oral ondansetron for emetogenic chemotherapy. Pharmacotherapy 20:1318–1323PubMedCrossRef
24.
Hesketh P, Navari R, Grote T (1996) Double-blind, randomized comparison of the antiemetic efficacy of intravenous dolasetron mesylate and intravenous ondansetron in the prevention of acute cisplatin-induced emesis in patients with cancer. Dolasetron Comparative Chemotherapy-induced Emesis Prevention Group. J Clin Oncol 14:2242–2249PubMed
25.
Huc P, Block S, Carlier D et al (1998) Oral granisetron versus oral ondansetron for the prevention of nausea and vomiting induced by moderately emetogenic chemotherapies. Bull Cancer (Paris) 85:562–568
26.
Italian Group for Antiemetic Research in Radiotherapy (1999) Radiation-induced emesis: a prospective observational multicenter Italian trial. Int J Radiat Oncol Biol Phys 44:619–625CrossRef
27.
Italian Group for Antiemetic Research in Radiotherapy (1995) Ondansetron versus granisetron, both combined with dexamethasone, in the prevention of cisplatin-induced emesis. Ann Oncol 6:805–810
28.
Jantunen I, Kataja V, Johansson R (1992) Ondansetron and tropisetron with dexamethasone in the prophylaxis of acute vomiting induced by non-cisplatin-containing chemotherapy. Acta Oncol 31:573–575PubMed
29.
Jantunen I, Muhonen T, Kataja V et al (1993) 5-HT3 Receptor antagonists in the prophylaxis of acute vomiting induced by moderately emetogenic chemotherapy—a randomised study. Eur J Cancer 29A:1669–1672PubMedCrossRef
30.
Jordan K, Grothey A, Kegel T et al (2005) Antiemetic efficacy of an oral suspension of granisetron plus dexamethasone and influence of quality of life on risk for nausea and vomiting. Onkologie 28:88–92PubMedCrossRef
31.
Kaiser R, Sezer O, Papies A et al (2002) Patient-tailored antiemetic treatment with 5-hydroxytryptamine type 3 receptor antagonists according to cytochrome P-450 2D6 genotypes. J Clin Oncol 20:2805–2811PubMedCrossRef
32.
Kamanabrou D (1992) Intravenous granisetron—establishing the optimal dose. Eur J Cancer 28A:S6–S11PubMedCrossRef
33.
Krzakowski M, Graham E, Goedhals L et al (1998) A multicenter, double-blind comparison of i.v. and oral administration of ondansetron plus dexamethasone for acute cisplatin-induced emesis. Anti-Cancer Drugs 9:593–598PubMedCrossRef
34.
Kytril tablets prescribing information. Nutley NJ, USA: Roche Laboratories Inc, 2000
35.
Kytril® injection prescribing information. Nutley NJ, USA: Roche Laboratories Inc, 2000
36.
Laszlo J, (1983) Emesis as limiting toxicity in cancer chemotherapy. In: Laszlo J (ed) Antiemetics and cancer chemotherapy. Williams and Wilkins, Baltimore, pp, 1–5
37.
Lofters W, Pater J, Zee B et al (1997) Phase III double-blind comparison of dolasetron mesylate and ondansetron and an evaluation of the additive role of dexamethasone in the prevention of acute and delayed nausea and vomiting due to moderately emetogenic chemotherapy. J Clin Oncol 15:2966–2973PubMed
38.
Mabro M, Kerbrat P (1999) Etude comparative du granisetron per os et de l’ondansetron IV chez des patientes recevant une chimiotherapie pour un cancer du sein. Bull Cancer (Paris) 86:295–301
39.
Mantovani G, Maccio A, Bianchi A et al (1996) Comparison of granisetron, ondansetron, and tropisetron in the prophylaxis of acute nausea and vomiting induced by cisplatin for the treatment of head and neck cancer: a randomized controlled trial. Cancer 77:941–948PubMedCrossRef
40.
Martoni A, Angelelli B, Guarldi M et al (1996) An open randomised cross-over study on granisetron versus ondansetron in the prevention of acute emesis induced by moderate dose cisplatin-containing regimens. Eur J Cancer 32A:82–85PubMedCrossRef
41.
Martoni A, Piana E, Strocchi E et al (1988) Comparative crossover trial of two intravenous doses of granisetron (1 mg vs 3 mg) + dexamethasone in the prevention of acute cis-platinum-induced emesis. Anticancer Res 18:2799–2803
42.
Marty M, Kleisbauer J-P, Fournel P et al (1995) Is navoban (tropisetron) as effective as zofran (ondansetron) in cisplatin-induced emesis? Anti-Cancer Drugs 6:15–21PubMedCrossRef
43.
Massidda B, Ionata M (1996) Prevention of delayed emesis by a single intravenous bolus dose of 5-HT3-receptor-antagonist in moderately emetogenic chemotherapy. J Chemother 8:237–242PubMed
44.
Massidda B, Laconi S, Foddi M et al (1994) Prevention of non-cisplatin induced emesis: role of the antagonists of 5-HT3 receptors. Ann Oncol 5:204
45.
Mendarte L, Aguas CM, Martinez BE et al (2000) Meta-analysis of granisetron versus ondansetron: efficacy and safety in the prevention of acute emesis induced by high dose cisplatin containing schedules. Med Clin (Barcelona) 115:456–460
46.
Monde M, Grazie M, De Vita F et al (1994) Tropisetron vs granisetron nell’emesi acuta e ri-tardata indotta da cis-platino: dati preliminary. Tumori 80:150 (Abstr 428)
47.
Multinational Association for Supportive Care in Cancer (2005) Antiemetic guidelines from the Consensus Conference on Antiemetic Therapy. Perugia International Cancer Conference VII. Perugia, Italy; 29–31 March 2004. Support Care Cancer 13:77–79; 80–84; 85–96; 97–103; 104–108; 109–111; 112–116; 117–121; 122–128; 129–131
48.
Nakamura H, Taira O, Kodaira S (1999) A multicenter randomized parallel comparison of granisetron injection (GRA) with ondansetron injection (OND) in the acute emesis induced by emetogenic chemotherapy. Proc ASCO 1999 Annual Meeting, (Abstr 2324)
49.
Navari R, Gandara D, Hesketh P et al (1995) Comparative clinical trial of granisetron and ondansetron in the prophylaxis of cisplatin-induced emesis. J Clin Oncol 13:1242–1248PubMed
50.
Navari R, Kaplan H, Gralla R et al (1994) Efficacy and safety of granisetron, a selective 5-hydroxytryptamine-3 receptor antagonist, in the prevention of nausea and vomiting induced by high-dose cisplatin. J Clin Oncol 12:2204–2210PubMed
51.
Newberry N, Watkins C, Sprosen T et al (1993) BRL 46470 potently antagonizes neural responses activated by 5-HT3 receptors. Neuropharmacology 32:729–735PubMedCrossRef
52.
Noble A, Bremer K, Goedhals L et al (1994) A double-blind, randomised, crossover comparison of granisetron and ondansetron in 5-day fractionated chemotherapy: assessment of efficacy, safety and patient preference. Eur J Cancer 30A:1083–1088PubMedCrossRef
53.
Öge A, Alkis N, Öge O et al (2000) Comparison of granisetron, ondansetron and tropisetron for control of vomiting and nausea induced by cisplatin. J Chemother 12:105–108PubMed
54.
Osoba D, Zee B, Warr D et al (1996) Quality of life studies in chemotherapy-induced emesis. Oncology 53(Suppl 1):92–95PubMedCrossRef
55.
Park O, Rha S, Yoo N et al (1997) A comparative study of intravenous granisetron versus intravenous and oral ondansetron in the prevention of nausea and vomiting associated with moderately emetogenic chemotherapy. Am J Clin Oncol 20:569–572PubMedCrossRef
56.
Pectasides D, Mylonakis A, Varthalitis J et al (1997) Comparison of two different doses of ondansetron plus dexamethasone in the prophylaxis of cisplatin-induced emesis. Oncology 54:1–6PubMedCrossRef
57.
Perez E, Hesketh P, Sandbach J et al (1998) Comparison of single-dose oral granisetron versus intravenous ondansetron in the prevention of nausea and vomiting induced by moderately emetogenic chemotherapy: a multicenter, double-blind, randomized parallel study. J Clin Oncol 16:754–760PubMed
58.
Perez E, Navari R, Kaplan H et al (1997) Efficacy and safety of different doses of granisetron for the prophylaxis of cisplatin-induced emesis. Support Care Cancer 5:31–37PubMedCrossRef
59.
Pinkerton C, Jacobson S, Leclerc J et al (1993) IV granisetron in children receiving highly emetogenic chemotherapy: a double-blind dose ranging study. Eur J Cancer 29A:S200CrossRef
60.
Ruff P, Paska W, Goedhals L et al (1994) Ondansetron compared with granisetron in the prophylaxis of cisplatin-induced acute emesis: a multicentre double-blind, randomised, parallel-group study. Oncology 51:113–118PubMed
61.
Seynaeve C, Schuller J, Buser K et al (1992) Comparison of the anti-emetic efficacy of different doses of ondansetron, given as either a continuous infusion or a single intravenous dose, in acute cisplatin-induced emesis. A multicentre, double-blind, randomised, parallel group study. Br J Cancer 66:192–197PubMed
62.
Smith I (1990) A comparison of two dose levels of granisetron in patients receiving moderately emetogenic cytostatic chemotherapy. Eur J Cancer 26:S19–S23PubMed
63.
Soukop M (1990) A comparison of two dose levels of granisetron in patients receiving high-dose cisplatin. Eur J Cancer 26:S15–S19PubMed
64.
Spector J, Lester E, Chevlen E et al (1998) A comparison of oral ondansetron and intravenous granisetron for the prevention of nausea and emesis associated with cisplatin-based chemotherapy. Oncologist 3:432–438PubMed
65.
Stewart A, McQuade B, Cronje J et al (1995) 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 52:202–210PubMedCrossRef
66.
Tan M, Xu R, Seth R (2004) Granisetron vs dolasetron for acute chemotherapy-induced nausea and vomiting (CINV) in high and moderately high emetogenic chemotherapy: an open-label pilot study. Curr Med Res Opin 20:879–882PubMedCrossRef
67.
Tsavaris N, Kosmas M, Vadiaka M et al (2001) Efficacy of ondansetron treatment for acute emesis with different dosing schedules 8 vs 32 mg. A randomized study. J Exp Clin Cancer Res 20:29–34PubMed
68.
Whitehead A (2002) Meta-analysis of controlled clinical trials. Wiley, London
69.
Yalçin S, Tekuzman G, Baltali E et al (1999) Serotonin receptor antagonists in prophylaxis of acute and delayed emesis induced by moderately emetogenic, single-day chemotherapy. Am J Clin Oncol 22:94–96PubMedCrossRef
70.
Yusuf S, Peto R, Lewis J et al (1985) Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis 27:335–371PubMedCrossRef
71.
Zhang P, Sun Y, Zhang H (1996) A randomized trial of tropisetron in the prophylaxis of nausea and vomiting induced by chemotherapy. Zhonghua Zhongliu Zazhi 18:154–156PubMed
72.
Zofran® (ondansetron hydrochloride) injection [US prescribing information]. Research Triangle Park, NC 27709, USA: GlaxoSmithKline
73.
Zofran® (ondansetron hydrochloride) tablets and oral solution [US prescribing information]. Research Triangle Park, NC 27709, USA: GlaxoSmithKline
Metadata
Title
A meta-analysis comparing the efficacy of four 5-HT3-receptor antagonists for acute chemotherapy-induced emesis
Authors
K. Jordan
A. Hinke
A. Grothey
W. Voigt
D. Arnold
H.-H. Wolf
H.-J. Schmoll
Publication date
01-09-2007
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 9/2007
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-006-0186-7

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