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A systematic review and meta-analysis of intravenous palonosetron in the prevention of chemotherapy-induced nausea and vomiting in adults
- Source :
- The oncologist. 16(2)
- Publication Year :
- 2011
-
Abstract
- Objectives. We performed a systematic review and meta-analysis to compare treatment effectiveness and adverse effects in cancer patients receiving chemotherapy with palonosetron to prevent chemotherapy-induced nausea and vomiting (CINV). Methods. We identified randomized controlled clinical trials (RCT) comparing palonosetron with first-generation 5-HT3RA in the prevention of CINV in cancer patients. Meta-analyses were performed on homogeneous studies. Fixed or random-effects models were used to combine data. Results. Eight eligible trials were identified, reporting outcomes on 3,592 patients. Meta-analyses showed statistically significant differences in favor of palonosetron compared with first-generation 5-HT3RA in prevention of acute CINV (p = .0003), delayed CINV (p < .00001), and overall phase of CINV (p < .00001). Subgroup analyses showed statistically significant differences in favor of both 0.25 mg and 0.75 mg of palonosetron in prevention of all phases of CINV. There were no statistically significant differences between 0.25 and 0.75 mg of palonosetron. Compared with the first-generation 5-HT3RA, 0.75 mg of palonosetron showed a statistically significant difference in the occurrence of constipation (p = .04). Interpretation. The use of palonosetron should be considered an integral part of adjuvant therapy for prevention of the acute, delayed, and overall phases of CINV. The 0.25 mg intravenous palonosetron dose is as effective as the 0.75 mg intravenous palonosetron dose. However, 0.75 mg intravenous palonosetron causes constipation more frequently than the first-generation 5-HT3RA.
- Subjects :
- Adult
Cancer Research
medicine.medical_specialty
Quinuclidines
Nausea
Vomiting
Antineoplastic Agents
Dexamethasone
law.invention
Randomized controlled trial
law
Internal medicine
Neoplasms
medicine
Humans
Serotonin 5-HT3 Receptor Antagonists
Adverse effect
Infusions, Intravenous
business.industry
Palonosetron
Headache
Isoquinolines
Clinical trial
Treatment Outcome
Oncology
Symptom Management and Supportive Care
Meta-analysis
Anesthesia
Antiemetics
medicine.symptom
business
Constipation
medicine.drug
Chemotherapy-induced nausea and vomiting
Subjects
Details
- ISSN :
- 1549490X
- Volume :
- 16
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- The oncologist
- Accession number :
- edsair.doi.dedup.....12bfe88999ebba9d06f256e5bba50e27