Prevention of cisplatin-induced delayed emesis: still unsatisfactory

The incidence of and prognostic factors in cisplatin-induced delayed emesis were evaluated in 522 naive cancer patients. They each received an intrave nous combination of ondansetron and one of four different doses of dexameth asone for the prevention of acute emesis and a combination of orally admini stered metoclopramide plus intramuscular dexamethasone for the prevention o f delayed emesis. Despite the best prophylaxis for acute and delayed emesis , 37.4% / 57.1% of patients experienced delayed vomiting / nausea. The pres ence of acute vomiting / nausea was the main prognostic factor in delayed v omiting / nausea; therefore, a multifactorial analysis of the results achie ved during the delayed phase adjusted for those obtained during the acute p hase should be carried out in every study evaluating the efficacy of differ ent antiemetic drugs for delayed emesis.