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Effective cross-over to granisetron after failure to ondansetron, a randomized double blind study in patients failing ondansetron plus dexamethasone during the first 24 hours following highly emetogenic chemotherapy.

Author(s): de Wit R, de Boer AC, vd Linden GH, Stoter G, Sparreboom A, Verweij J

Affiliation(s): Rotterdam Cancer Institute and University Hospital Rotterdam, IJsselland Hospital Rotterdam, Albert Schweitzer Hospital Dordrecht, The Netherlands.

Publication date & source: 2001-10-19, Br J Cancer., 85(8):1099-101.

Publication type: Clinical Trial; Randomized Controlled Trial

In view of the similarity in chemical structure of the available 5HT(3)-receptor antagonists it is assumed, whilst these agents all act at the same receptor, that failure to one agent would predict subsequent failure to all 5HT(3)-receptor antagonists. We conducted a randomized double blind trial of granisetron 3 mg plus dexamethasone 10 mg versus continued treatment with ondansetron 8 mg plus dexamethasone 10 mg in patients with protection failure on ondansetron 8 mg plus dexamethasone 10 mg during the first 24 hours following highly emetogenic chemotherapy. Of 40 eligible patients, 21 received ondansetron + dexamethasone and 19 received granisetron + dexamethasone. We found a significant benefit from crossing-over to granisetron after failure on ondansetron. Of the 19 patients who crossed over to granisetron, 9 patients obtained complete protection, whereas this was observed in 1 of the 21 patients continuing ondansetron, P = 0.005. These results indicate that there is no complete cross-resistance between 5HT(3)-receptor antagonists, and that patients who have acute protection failure on one 5HT(3)-receptor antagonist should be offered cross-over to another 5HT(3)-receptor antagonist. Copyright 2001 Cancer Research Campaign http://www.bjcancer.com.

Page last updated: 2006-01-31

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