Metoclopramide, Dexamethasone, or Palonosetron for Prevention of Delayed Chemotherapy-Induced Nausea and Vomiting After Moderately Emetogenic Chemotherapy (MEDEA): A Randomized, Phase III, Noninferiority Trial.
Maurice J D L van der VorstElisa C ToffoliMarlien BeusinkMyra E van LindeTheo van VoorthuizenSaskia BrouwerAnnette A van ZweedenSuzan VrijaldenhovenJohan C BerendsJohannes BerkhofHenk M W VerheulPublished in: The oncologist (2020)
Chemotherapy-induced nausea and vomiting (CINV) in the delayed phase (24-120 hours after chemotherapy) remains one of the most troublesome adverse effects associated with cancer treatment. In particular, delayed nausea is often poorly controlled. The role of dexamethasone (DEX) in the prevention of delayed nausea after moderately emetogenic chemotherapy (MEC) is controversial. This study is the first to include nausea assessment as a part of the primary study outcome to better gauge the effectiveness of CINV control and patients' experience. Results show that a DEX-sparing strategy does not result in any significant loss of overall antiemetic control: DEX-sparing strategies incorporating palonosetron or multiple-day metoclopramide are safe and at least as effective as standard treatment with a 3-day DEX regimen with ondansetron in controlling delayed CINV-and nausea in particular-following MEC.
Keyphrases
- chemotherapy induced
- phase iii
- end stage renal disease
- clinical trial
- open label
- low dose
- randomized controlled trial
- systematic review
- chronic kidney disease
- high dose
- ejection fraction
- phase ii
- study protocol
- squamous cell carcinoma
- radiation therapy
- peritoneal dialysis
- prognostic factors
- combination therapy
- placebo controlled