[Comparative Study of the Antiemetic Palonosetron for Lung Cancer Patients Treated with a Divided Dose of Cisplatin].

Palonosetron(Palo)is a second-generation 5-hydroxytryptamine 3 receptor antagonist(5-HT3RA)effective in suppressing chemotherapy-induced nausea and vomiting in both acute and delayed phases.Most studies have reported Palo as an effective antiemetic for cisplatin(CDDP)chemotherapy(≥50mg/m2)administered on an intermittent basis.To assess the antiemetic efficacy of Palo, we performed a retrospective study in 16 patients with lung cancer who received Palo with split-dose CDDP, ifosfamide, and irinotecan(CPT-11)triple combination(CIC)therapy at Sapporo Minami-Sanjo Hospital between October 2010 and January 2012.T he CIC regimen consisted of CPT-11(50-60mg/m2)administered on days 1, 8, and 15, in addition to CDDP(15-20mg/m2)and ifosfamide(1,500mg/kg)for 4 consecutive days.On day 1, ramosetron was replaced with Palo in patients who had insufficient antiemetic control in accordance with guidelines on the management of highly emetogenic chemotherapy(HEC).There was a lower incidence of grade 1 or higher nausea(62.5%)in patients in the Palo-combination group than in those in the non-Palo-combination group(87.5%).No incidence of grade 3 or higher nausea was reported in either group.On the fifth day of chemotherapy, the incidence of nausea was significantly lower in the Palo-combination group(43.8%)than in the non-Palo-combination group(81.3%)(p<0.05).In addition, there was a significant decrease in the number of days of incidence and a significant increase in the number of days since the last episode was observed in the Palo-combination group.These results suggest that Palo, in particular, decreases the incidence of nausea and extends the number of days since its occurrence; moreover, it is effective in accelerating recovery.In conclusion, this study suggests that Palo exhibits excellent antiemetic efficacy in patients administered split doses of CDDP.