J Gynecol Oncol.  2018 Sep;29(5):e77. 10.3802/jgo.2018.29.e77.

Efficacy of palonosetron plus dexamethasone in preventing chemotherapy-induced nausea and emesis in patients receiving carboplatin-based chemotherapy for gynecologic cancers: a phase II study by the West Japan Gynecologic Oncology Group (WJGOG 131)

Affiliations
  • 1Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan. shinshin@med.kurume-u.ac.jp
  • 2Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan.
  • 3Clinical Research Institute, National Kyushu Cancer Center, Fukuoka, Japan.
  • 4Department of Obstetrics and Gynecology, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
  • 5Department of Obstetrics and Gynecology, Miyazaki Prefectural Hospital, Miyazaki, Japan.
  • 6Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Kitakyushu, Japan.
  • 7Department of Gynecology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.
  • 8Department of Obstetrics and Gynecology, Kagoshima University School of Medicine, Kagoshima, Japan.
  • 9Department of Obstetrics and Gynecology, St. Mary's Hospital, Kurume, Japan.
  • 10Department of Obstetrics and Gynecology, Tokuyama Central Hospital, Shunan, Japan.
  • 11Department of Obstetrics and Gynecology, Nagasaki Harbor Medical Center City Hospital, Nagasaki, Japan.
  • 12Department of Obstetrics and Gynecology, NHO Kokura Medical Center, Kitakyushu, Japan.
  • 13Department of Obstetrics and Gynecology, Kyushu Rosai Hospital, Kitakyushu, Japan.

Abstract


OBJECTIVE
Palonosetron is effective for the management of acute and delayed chemotherapy-induced nausea and vomiting (CINV). While emetogenic carboplatin-based chemotherapy is widely used to treat gynecologic cancers, few studies have evaluated the antiemetic effectiveness of palonosetron in this setting.
METHODS
A multicenter, single-arm, open-label phase II trial was conducted to evaluate the safety and effectiveness of palonosetron in controlling CINV in patients with gynecologic cancer. Chemotherapy-naïve patients received intravenous palonosetron (0.75 mg/body) and dexamethasone before the infusion of carboplatin-based chemotherapy on day 1. Dexamethasone was administered (orally or intravenously) on days 2-3. The incidence and severity of CINV were evaluated using the patient-completed Multinational Association of Supportive Care in Cancer Antiemesis Tool and treatment diaries. The primary endpoint was the proportion of patients experiencing complete control (CC) of vomiting, with "no rescue antiemetic medication" and "no clinically significant nausea" or "only mild nausea" in the delayed phase (24-120 hours post-chemotherapy). Secondary endpoints were the proportion of patients with a complete response (CR: "no vomiting" and "no rescue antiemetic medication") in the acute (0-24 hours), delayed (24-120 hours), and overall (0-120 hours) phases, and CC in the acute and overall phases.
RESULTS
Efficacy was assessable in 77 of 80 patients recruited. In the acute and delayed phases, the CR rates the primary endpoint, were 71.4% and 59.7% and the CC rates, the secondary endpoint, were 97.4% and 96.1%, respectively.
CONCLUSION
While palonosetron effectively controls acute CINV, additional antiemetic management is warranted in the delayed phase after carboplatin-based chemotherapy in gynecologic cancer patients (Trial registry at UMIN Clinical Trials Registry, UMIN000012806).

Keyword

Palonosetron; Carboplatin; Nausea; Vomiting; Gynecologic Neoplasm
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