Abstract
Palonosetron, a second-generation 5-hydroxytryptamine 3 receptor antagonist (5-HT3RA), has a higher binding affinity for the 5-HT3 receptor and a longer half-life than the first-generation 5-HT3RAs. The efficacy of palonosetron as prophylaxis for chemotherapy-induced nausea and vomiting has been reported. However, there are no reports of efficacy in patients with failure of antiemetic prophylaxis. In this study, we retrospectively investigated the efficacy of palonosetron used in subsequent chemotherapy cycles in patients with failure of antiemetic prophylaxis. A total of 50 patients were included from August 2010 to January 2013; 27 patients received highly emetogenic chemotherapy and 23 received moderately emetogenic chemotherapy. Antiemetic was switched from granisetron to palonosetron for all patients. The proportion of patients who experienced reduced severity of nausea were 60% in the acute phase, and the proportion of patients with reduced severity of nausea and vomiting were 90% and 66% in the delayed phase, respectively. The proportion of patients who used rescue medications decreased from 48% to 24%. We confirmed improvement of chemotherapy-induced nausea and vomiting by switching from granisetron to palonosetron in patients with failure of antiemetic prophylaxis.
