CURATIVE EFFICACY OF ONDANSETRON AGAINST NAUSEA AND EMESIS INDUCED BYANTICANCER DRUGS - A STUDY VERSUS METOCLOPRAMIDE

Twenty-two patients who experienced nausea or vomiting within eight ho urs after administration of weakly emetogenic anticancer drugs not pre ceded by prophylactic antiemetic therapy were entered into a double-bl ind randomized trial of 8 mg ondansetron (OND, n=11) versus 2 mg/kg me toclopramide (MCP; n=11). Each antiemetic was given as a slow intraven ous injection. Eight hours later oral therapy with the same antiemetic was initiated, in a dose of one 8-mg tablet of OND or two 10-mg table ts of MCP every eight hours for three to five days. The number of vomi ting episodes (VE) that occurred between the injection of the antiemet ic drug and the end of the 24th hour after anticancer drug administrat ion (D1) was recorded. Responses to therapy were categorized as follow s: complete (0 VEs), major (1 to 2 VEs), minor (3 to 5 VEs), and absen t (> 5 VEs or rescue therapy). Successful therapy was defined as a maj or or complete response (0 to 2 VEs). Complete response rates on D1 we re 55% (6/11) in the OND group and 18% (2/11) in the MCP group. This d ifference was significant (p = 0.04). The large number of study withdr awals for inefficacy in the MCP group precluded statistical analysis o f success rates beyond D1. In conclusion, ondansetron is superior over metoclopramide in terms of curative antiemetic efficacy in patients w ith nausea and vomiting induced by weakly emetogenic anticancer agents .