Prevention of delayed emesis induced by moderately emetogenic chemotherapyin patients with acute emesis - A pilot study with ACTH-Depot plus tropisetron

The rates of delayed nausea and vomiting by moderately emetogenic chemother apy in patients with previous experience of acute emesis are usually quite high. This is a pilot study aiming to evaluate the safety of a new antiemet ic schedule to prevent delayed emesis in this subset of patients. During 5 consecutive cycles of moderately emetogenic chemotherapy, we evalu ated 50 patients (15 males) who experienced acute emesis in the first cycle of treatment. The regimen for prevention of delayed emesis consisted of da ily tropisetron (5 mg orally from d 2 to d 6 of each chemotherapeutic cycle ) associated to ACTH-Depot (1 mg intramuscularly 24 and 68 h after the init iation of chemotherapy). In 77% of chemotherapy cycles, there was a total elimination of nausea and vomiting, whereas in the remaining 23% of cycles, there was a major respons e defined as less than or equal to 2 vomiting episodes per cycle or nausea grade 1 according to the WHO. The efficacy of the antiemetic regimen persis ted during the entire treatment program without the appearance of toxic eff ects. The proposed antiemetic regimen is highly active in preventing delayed naus ea and vomiting episodes in patients receiving moderately emetogenic chemot herapy. Moreover, no toxic effects were observed. These promising results r equire confirmation by a randomized trial.