Authors:
Cindy L. Dempsey, Pharm.D
Andrew J. Coop, MBChB.
Alicia Shillington, Ph.D.
P. Anne Farley, RN, MSM
Douglas R. Eberhardt, MS, MBA
Sharon O’Briant, Pharm.D.

Abstract:

OBJECTIVE:
The antiemetic effectiveness of ondansetron 8 mg i.v., ondansetron 32 mg i.v., and granisetron 10 mcg/kg or 1 mg i.v. as prophylaxis in breast cancer patients receiving cyclophosphamide-containing regimens was studied.

METHODS:
Data from six U.S. cancer centers were collected retrospectively for 224 patients who received cyclophosphamide-containing therapy between January 1998 and June 2002. Logistic-regression analysis was used to examine the likelihood of chemotherapyinduced nausea and vomiting (CINV) both on an unadjusted basis and controlling for concomitant radiation therapy and dexamethasone use.

RESULTS:
Seventy-six patients (34%) received ondansetron 32 mg, 68 (30%) received ondansetron 8 mg, and 80 (36%) received granisetron (either 10 mcg/kg or 1 mg). Patients receiving ondansetron 8 mg were 2.5 times as likely to have CINV on an adjusted basis as granisetron recipients (p < 0.01). There was no increase in the risk of CINV with ondansetron 32 mg compared with granisetron. Patients treated with ondansetron 8 mg required more rescue antiemetics and more prophylactic antiemetics in subsequent chemotherapy cycles than patients in the other groups.

CONCLUSION:
In a retrospective multicenter study, granisetron 1 mg or 10 mcg/kg and ondansetron 32 mg appeared more effective than ondansetron 8 mg in preventing acute CINV related to cyclophosphamide therapy.