Protection from nausea and vomiting in cisplatin-treated patients: high-dose metoclopramide combined with methylprednisolone versus metoclopramide combined with dexamethasone and diphenhydramine: a study of the Italian Oncology Group for Clinical Research.

• DOI: 10.1200/jco.1989.7.11.1693
• Publication Date: 2017-02-23T17:57:38Z
• Authors: F Roila; M Tonato; C Basurto; M Picciafuoco; S Bracarda; D Donati; P Malacarne; L Monici; F Di Costanzo; L Patoia
• Keywords: Metoclopramide

Despite treatment, emesis remains a major problem with cisplatin (CDDP) chemotherapy. Reasons for variability in antiemetic response among patients and subsequent cycles are largely unknown toxicity is sometimes severe. We have, therefore, carried out multicenter, double-blind randomized trial comparing combination of high-dose metoclopramide (MTC) (1 mg/kg x 4) methylprednisolone (P) (treatment A) shorter but higher single-dose schedule (3 2) combined dexamethasone (DEX) diphenhydramine (DIP) to prevent extrapyramidal reactions B). Three hundred sixty-seven consecutive treated various chemotherapy combinations containing CDDP were studied. Complete protection from vomiting/nausea was, at first cycle, 72.5%/79.5% treatment B 55.8%/65.1% A, statistically significant difference (P less than .002/P .005). In cycles, significantly decreased no between the two treatments. Multifactorial analysis shows that women, younger patients, outpatients, who experienced previous risk suffering nausea and/or vomiting. Both regimens well tolerated, had (1.7%/6.1%, P = .053). Treatment preferred due its greater efficacy lower incidence reactions. Trials on therapy should take into account important variables able influence treatment. There still need improving prevention CDDP-treated patients.