Antiemetic efficacy of combination therapy with granisetron plus prednisolone plus the dopamine D-2 antagonist metopimazine during multiple cycles ofmoderately emetogenic chemotherapy in patients refractory to previous antiemetic therapy

Effective antiemetic treatment of patients who have previously experienced chemotherapy-induced nausea and vomiting is difficult. The aim of this stud y was to evaluate the antiemetic efficacy of a single intravenous dose of g ranisetron plus a 3-day oral treatment with prednisolone 25 mg once a day p lus metopimazine 30 mg four times a day in patients refractory to previous antiemetic treatment with granisetron or with prednisolone plus metopimazin e. The study population was made up of 25 consecutive women with stage I or II breast cancer, who were treated with multiple cycles of adjuvant cyclop hosphamide, fluorouracil plus methotrexate or cyclophosphamide, epirubicin plus fluorouracil given i.v. every 3 weeks. Patients received the three-dru g combination of antiemetics during a total of 113 cycles of chemotherapy, No emetic episodes were reported in 88.9% cycles on day 1, in 94.7% cycles on days 2 through 5 and in 85.8% cycles on days 1 through 5 after chemother apy. No nausea was reported in 43.4% cycles on day 1, in 49.6% cycles on da ys 2 through 5 and in 34.5% cycles on days 1 through 5, Nineteen patients ( 76.0%) completed the scheduled nine cycles of chemotherapy, 1 being withdra wn because of greater than or equal to 5 emetic episodes and 5, because the y were not satisfied with the antiemetic treatment. The treatment was well tolerated. In conclusion, granisetron plus prednisolone plus metopimazine i s a highly effective antiemetic treatment in patients receiving moderately emetogenic chemotherapy refractory to antiemetic therapy with granisetron o r prednisolone plus metopimazine.