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Supportive Care in Cancer
Published in: Supportive Care in Cancer 6/2011

01-06-2011 | Original Article

Efficacy of palonosetron (PAL) compared to other serotonin inhibitors (5-HT3R) in preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately or highly emetogenic (MoHE) treatment: systematic review and meta-analysis

Authors: Tobias Engel Ayer Botrel, Otávio Augusto C. Clark, Luciana Clark, Luciano Paladini, Enéas Faleiros, Bruna Pegoretti

Published in: Supportive Care in Cancer | Issue 6/2011

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Abstract

Objective

The objective of this work is to perform a systematic review and meta-analysis of all randomized controlled trials comparing a single intravenous dose of palonosetron (PAL) 0.25 mg with other 5-HT3R in patients receiving moderately or highly emetogenic (MoHE) chemotherapy.

Methods

Several databases were searched, including MEDLINE, EMBASE, LILACS, and CENTRAL. The primary endpoints were the incidence of acute and delayed nausea and vomiting. The side effects of each treatment were analyzed. A subgroup analysis was performed to evaluate the influence of the use of corticosteroids. The results are expressed as risk ratio (RR) and the correspondent 95% confidence interval (CI).

Results

Five studies were included, with 2,057 patients. PAL was compared with ondansetron, granisetron, and dolasetron. Patients in PAL group had less nausea, both acute (RR = 0.86; CI95% = 0.76 to 0.96; p = 0.007) and delayed (RR = 0.82; CI95% = 0.75 to 0.89; p < 0.00001). They also had less acute vomiting (RR = 0.76; CI95% = 0.66 to 0.88; p = 0.0002) and delayed vomiting (RR = 0.76; CI95% = 0.68 to 0.85; p < 0.00001). There were no statistical differences in side effects like headache (RR = 0.84; CI95% = 0.61 to 1.17; p = 0.30), dizziness (RR = 0.40; CI95% = 0.13 to 1.27; p = 0.12), constipation (RR = 1.29; CI95% = 0.77 to 2.17; p = 0.33) or diarrhea (RR = 0.67; CI95% = 0.24 to 1.85; p = 0.44). Patients receiving PAL presented less nausea and vomiting regardless of the use of corticoids. We found no statistical heterogeneity in the global analysis.

Conclusion

PAL was more effective than the other 5-HT3R in preventing acute and delayed CINV in patients receiving MoHE treatments, regardless of the use of concomitant corticosteroids.
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Metadata
Title
Efficacy of palonosetron (PAL) compared to other serotonin inhibitors (5-HT3R) in preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately or highly emetogenic (MoHE) treatment: systematic review and meta-analysis
Authors
Tobias Engel Ayer Botrel
Otávio Augusto C. Clark
Luciana Clark
Luciano Paladini
Enéas Faleiros
Bruna Pegoretti
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 6/2011
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-010-0908-8

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