Jp. Kleisbauer et al., GRANISETRON PLUS METHYLPREDNISOLONE FOR THE CONTROL OF HIGH-DOSE CISPLATIN-INDUCED EMESIS, Anti-cancer drugs, 9(5), 1998, pp. 387-392
This double-blind, double-dummy, randomized study compared the 24 h ef
ficacy and safety of granisetron alone (3 mg i.v. over 30 s) or in com
bination with methylprednisolone (250 mg i.v. twice daily) in preventi
ng nausea and vomiting in 308 patients (254 males) receiving high-dose
cisplatin (100 mg/m(2) or above) for mainly lung, and head and neck c
ancers. All patients received oral follow-on therapy comprising oral g
ranisetron and methylprednisolone during the following 6 days. Primary
efficacy variables were the proportions of complete responses (CR; no
vomiting, no worse than mild nausea, no rescue and no withdrawal), no
vomiting and no nausea over the first 24 h following initiation of th
e cisplatin infusion. The two treatment groups were well matched for d
emographics, cancer site, cisplatin dose and duration of infusion. Gra
nisetron plus methylprednisolone was significantly more effective than
granisetron alone for all primary efficacy variables: CR 78 versus 59
% (p<0.001), no vomiting 80 versus 61% (p<0.001) and no nausea 74 vers
us 57% (p<0.002). Significantly more patients receiving the combinatio
n were free of any emetic symptoms (74 versus 54%, p<0.001). Significa
ntly fewer patients receiving combination therapy also required rescue
therapy with i.v. granisetron (12.2 versus 21.7%, p=0.026). During th
e follow-on period, complete response rates varied day by day from 50
to 71%. Both treatments were well tolerated, with constipation, abdomi
nal pain and headache as the most frequent adverse events. [(C) 1998 L
ippincott-Raven Publishers.].