Randomised comparison of ondansetron plus dexamethasone with dexamethasonealone for the control of delayed cisplatin-induced emesis

The role of 5-hydroxytryptamine(3) (HT3) antagonists in the treatment of de layed emesis is still controversial. To evaluate whether 5-HT3 antagonists can add to the efficacy of corticosteroids in controlling delayed emesis, w e performed a randomised, prospective, open study comparing ondansetron plu s dexamethasone with dexamethasone alone in cisplatin-treated patients. 149 cisplatin-naive patients with lung cancer received at least 60 mg.m(2) of cisplatin and were treated with dexamethasone 32 mg intravenously (i.v.) an d granisetron 3 mg i.v. on day I. Patients were randomly assigned to receiv e either dexamethasone 16 mg i.v. alone (arm A) or dexamethasone plus ondan setron 8 mg daily (arm B) on days 2-4. None of the efficacy variables relat ed to control of delayed emesis differed significantly between the two arms . In conclusion, there does not appear to be sufficient evidence to support the prolonged use of 5-HT3 receptor antagonists after 24 h of cisplatin-co ntaining chemotherapy. (C) 2001 Elsevier Science Ltd. All rights reserved.