IMPROVED CONTROL OF HIGH-DOSE-CISPLATIN-INDUCED ACUTE EMESIS WITH THEADDITION OF PROCHLORPERAZINE TO GRANISETRON DEXAMETHASONE/

PURPOSE To evaluate the antiemetic efficacy and safety of adding the d opamine antagonist prochlorperazine to the combination of granisetron and daxamethasone in the prevention of acute nausea and vomiting follo wing high-dose cisplatin. PATIENTS AND METHODS Sixty patients receivin g cisplatin (greater than or equal to 75 mg/m(2)) (median dose = 100 m g/m(2)) were enrolled at three sites. Patients received prochlorperazi ne spansule 15 mg orally, Go minutes prior to and 12 hours after cispl atin; dexamethasone 20 mg intravenously, 45 minutes prior to cisplatin , and 10 mg intravenously or orally, 12 hours after cisplatin; and gra nisetron 10 mu/kg intravenously, 30 minutes prior to cisplatin. Effica cy was assessed during the 24-hour period after cisplatin using comple te antiemetic response (no emetic episodes and no rescue antiemetics) and patient assessment of nausea and satisfaction using 100-mm visual analog scales (nausea: 0 = none, 100 = nausea as bad as it can be; sat isfaction: 0 = not at all satisfied, 100 = satisfied as can be). RESUL TS Complete response (0 emetic episodes) was noted in 84% (49/58) of p atients. Forty-two patients (72%) experienced no nausea. The mean chan ge in posttreatment nausea visual analog scales from baseline was 8.3 mm. Forty-eight patients (83%) were completely satisfied with their an tiemetic treatment. The mean posttreatment patient satisfaction score was 92 mm. Treatment was well tolerated, with infrequent and minor adv erse events. CONCLUSIONS This three-drug antiemetic regimen is well to lerated and highly effective in the prevention of acute nausea and vom iting arising from high-dose cisplatin. Further studies evaluating thi s regimen are warranted.