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High-dose dexamethasone for prevention of cis-platin-induced vomiting

  • Original Articles
  • Dexamethasone CDDP-induced Vomiting
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Summary

Severe, debilitating nausea and vomiting are seen in almost 100% of patients treated with cis-platinum. These side-effects can be so severe and prolonged as to preclude therapy in a large number of patients. Commonly used antiemetics have had only limited success in controlling cis-platinum-induced nausea and vomiting. Various reports have indicated benefits from steroids in this setting.

We have tested a high-dose dexamethasone regimen with or without neuroleptics, which inhibits chemotherapy-induced vomiting in 50% of patients failing with prior antiemetics and in 71% of those who had not received prior antiemetics. This treatment was administered on an out-patient basis as it involved oral administration of the antiemetic.

Neuroleptic therapy was not randomly assigned, but the results of this pilot study suggest that it did not enhance dexamethasone's efficacy. There were no significant side-effects due to the steroids. The antiemetic effectiveness of dexamethasone was retained through repeated courses of chemotherapy.

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References

  1. Baker JJ, Lokey JL, Price NA, Winokur SH, Bowen J, Taylor A (1979) Letter. N Engl J Med 301: 728

    Google Scholar 

  2. Bhakoo HS, Paolini NS, Milholland RJ, Lopez RE, Rosen F (1981) Glucocorticoid receptors and the effect of glucocorticoids on the growth of B-16 melanoma. Cancer Res 41: 1695–1701

    Google Scholar 

  3. Chang AE, Shiling DJ, Stillman RC, Goldberg NH, Seipp CA, Barofsky C, Simon RM, Rosenberg SA (1979) Delta-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate; a prospective randomized evaluation. Ann Intern Med 91: 819–824

    Google Scholar 

  4. Drapkin R, McAloon E, Sokol G, Paladine W, Marks R (1981) The antiemetic effect of dexamethasone in patients receiving cis-platinum. Proc ASCO 22: 340

    Google Scholar 

  5. Einhorn LH, Williams SD (1979) The role of cis-platinum in solid-tumor therapy. N Engl J Med 300: 289–291

    Google Scholar 

  6. Ekert H, Waters KD, Jurk IH, Mobilia J, Loughnan P (1979) Amelioration of cancer chemotherapy-induced nausea and vomiting by delta-9-tetrahydrocannabinol. Med J Aust 2: 657–659

    Google Scholar 

  7. Frytak S, Moertel CG, O'Fallon JR, Rubin J, Creagan ET, O'Connell MJ, Schutt AJ, Schwartao NW (1979) Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy: A comparison with prochlorperazine and a placebo. Ann Intern Med 91: 825–830

    Google Scholar 

  8. Frytak S, Moertel CG, Eagan RT, O'Fallon JR (1981) A double-blind comparison of metoclopramide and prochloperazine as antiemetics for platinum therapy. Proc ASCO 22: 350

    Google Scholar 

  9. Gralla RJ, Squillante A, Itri LM, Pisko S, Kelsen DP, Young CW (1981) High-dose metoclopramide: Effective antiemetic against cis-platin in randomized trials vs placebo and prochlorperazine. Proc ASCO 22: 344

    Google Scholar 

  10. Grossman B, Lessin LS, Cohen P (1980) Droperidol prevents nausea and vomiting from cis-platinum. N Engl J Med 301: 47

    Google Scholar 

  11. Gylys JA, Doran KM, Buyniski JP (1979) Antagonism of cis-platin induced emesis in the dog. Res Commun Chem Pathol Pharmacol 23: 61–68

    Google Scholar 

  12. Haid M (1981) Steroid antiemetics may be harmful. N Engl J Med 304: 1237

    Google Scholar 

  13. Herman TS, Einhorn LH, Jones SE, Magy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE (1979) Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy. N Engl J Med 300: 1295–1297

    Google Scholar 

  14. Kahn T, Elias EG, Mason GR (1978) A single dose of metloclopramide in the control of vomiting from cis-dichloro-diammineplatinum (II) in man. Cancer Treat Rep 62: 1106–1107

    Google Scholar 

  15. Lee BJ (1981) Methylprednisolone as an antiemetic. N Engl J Med 304: 486

    Google Scholar 

  16. Levitt M, Wilson A, Bowman D, Faiman C, Kemel S, Krepart G, Schipper H, Weinerman B, Weinerman R (1981) Dose vs response of tetrahydrocannabinol vs prochlorperazine as chemotherapy antiemetics. Proc ASCO 22: 352

    Google Scholar 

  17. Loeser EA, Bennett G, Stanley TH, Machin R (1979) Comparison of droperidol, haloperidol, and prochlorperazine as postoperative antiemetics. Can Anaesth Soc J 26: 125–127

    Google Scholar 

  18. Moertel CG, Reitemeier RJ (1969) Controlled clinical studies of orally administered drugs. Gastroenterology 57: 262–268

    Google Scholar 

  19. Neidhardt J, Gagen M, Metz E (1980) Haldol is an effective antiemetic for platinum- and mustard-induced vomiting when other agents fail. Proc ASCO 21: 365

    Google Scholar 

  20. Orr LE, McKernan JF, Bloome B (1980) Antiemetic effect of tetrahydrocannabinol, compared with placebo and prochlorperazine in chemotherapy-associated nausea and emesis. Arch Intern Med 140: 1431–1433

    Google Scholar 

  21. Plotkin DA, Plotkin D, Okum R (1973) Haloperidol in the treatment of nausea and vomiting due to cytotoxic drug administration. Curr Ther Res 15: 599–602

    Google Scholar 

  22. Rich WM, Abdulhayoglu G, DiSaia PJ (1980) Methylprednisolone as an antiemetic during cancer chemotherapy — a pilot study. Gynecol Oncol 9: 193–198

    Google Scholar 

  23. Robins IH, Ershler WB, DeJongh L, Chang YC, Drozdowicz PM, Carr BI, Meyer DK (1979) Antiemetic effect of intravenous diazepam in patients receiving cis-diamminedi-chloroplatinum II. A pilot study. Pediatr Oncol 27: 247–249

    Google Scholar 

  24. Rosenberg B (1975) Possible mechanisms for the antitumor activity of platinum coordination complexes. Cancer Chem Rep [1] 69: 589–598

    Google Scholar 

  25. Sallan SE, Cronin C, Zelen M, Zinberg NE (1980) Antiemetics in patients receiving chemotherapy for cancer, a randomized comparison of delta-9-tetrahydrocannabinol and prochlorperazine. N Engl J Med 302: 135–138

    Google Scholar 

  26. Strum SB, Opfell RW, McDermed JE, Reich LP (1981) Intravenous metoclopramide (MCP) inhibition of cis-platinum (DDP) induced nausea and vomiting. Proc ASCO 22: 231

    Google Scholar 

  27. Stryker JA, Demers LM, Mortel R (1979) Prophylactic ibuprofen administration during pelvic irradiation. Int J Radiat Oncol Biol Phys 5: 2049–2052

    Google Scholar 

  28. Tornetta FJ (1972) Double-blind evaluation of haloperidol for antiemetic activity. Anesth Analg (Cleve) 51: 964–967

    Google Scholar 

  29. Tornetta FJ (1977) A comparison of droperidol, diazepam, and hydroxyzine hydrochloride as premedication. Anesth Analg (Cleve) 56: 496–500

    Google Scholar 

  30. Wilson T, Weltz M, Molimando D, Perry D, Baldwin P, Kimball D (1981) Continuous infusion of droperidol: antiemetic therapy for cis-platinum toxicity. Proc ASCO 22: 351

    Google Scholar 

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Authors and Affiliations

  1. The Cancer Center, College of Medicine, University of Arizona, 85724, Tucson, AZ, USA

    Matti S. Aapro & David S. Alberts

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  1. Matti S. Aapro
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  2. David S. Alberts
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Aapro, M.S., Alberts, D.S. High-dose dexamethasone for prevention of cis-platin-induced vomiting. Cancer Chemother. Pharmacol. 7, 11–14 (1981). https://doi.org/10.1007/BF00258206

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  • DOI: https://doi.org/10.1007/BF00258206

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