ONDANSETRON PLUS DEXAMETHASONE VERSUS METOCLOPRAMIDE PLUS DEXAMETHASONE PLUS DIPHENHYDRAMINE IN CISPLATIN-TREATED PATIENTS WITH OVARIAN-CANCER

Female patients with ovarian cancer are at high risk for emesis. A stu dy evaluating the antiemetic activity and tolerability of ondansetron plus dexamethasone compared to metoclopramide plus dexamethasone plus diphenhydramine in this group of patients has been performed. A group of 63 patients with ovarian cancer undergoing cisplatin treatment were enrolled in the study. Vomiting, nausea and other side-effects were e valuated by the investigators during the first 24 h and recorded by th e patients on a diary card on days 2-4. Ondansetron plus dexamethasone showed a higher antiemetic activity during the first 24 h after cispl atin administration in all three cycles of cisplatin treatment, giving over 90% complete protection from vomiting at the first cycle. The ef ficacy of ondansetron plus dexamethasone decreased at the second cycle , but the percentage of complete protection from vomiting always remai ned better than 70%; there was poorer protection in the metoclopramide group, and its effect was similar during all three cycles. Ondansetro n plus dexamethasone was also found to be more efficacious than the me toclopramide regimen on the second day after cisplatin administration, while on days 3-4 a high rate of complete protection from emesis was achieved by both antiemetic therapies (> 80%). About 40%-55% of patien ts receiving ondansetron plus dexamethasone and about 65%-85% of patie nts treated with metoclopramide plus dexamethasone plus diphenhydramin e reported nausea or vomiting during days 1-4. Ondansetron plus dexame thasone is more efficacious than metoclopramide plus dexamethasone plu s diphenhydramine but new strategies to improve antiemetic efficacy in ovarian cancer patients must be out lined.