Do we still need to study palonosetron for chemotherapy-induced nausea and vomiting? A cumulative meta-analysis

Ronald Chow, M. Aapro, Rudolph M. Navari, Richard J. Gralla, Nicholas Chiu, Leonard Chiu, Stephanie Chan, M. Popovic, H. Lam, Michael Lock, C. DeAngelis

Research output: Contribution to journalReview article

1 Scopus citations

Abstract

Introduction: The aim is to conduct an updated systematic review comparing palonosetron to other 5-HT3RAs for the prophylaxis of CINV, assess for publication biases, and determine whether further RCTs are required, that could potentially lead to a different meta-conclusion. Methods: Random-effects analysis model was used to generate odds ratio (OR), risk differences (RD) and accompanying 95% confidence intervals (CI). Funnel plots to assess for biases and cumulative meta-analyses to assess effect size over time were generated. Results: 4145 patients were randomized to palonosetron and 4911 received other 5-HT3RAs. In the majority of efficacy endpoints, the meta-conclusion has not changed over time - recent clinical trials simply narrow CIs the meta-conclusion. Safety profile boasts a stable conclusion over time. No publication biases exist. Conclusion: Considering the vast amount of resources needed to conduct RCTs, resources should be dedicated to other prophylactic treatments/settings which have not been as well explored.

Original languageEnglish (US)
Pages (from-to)164-186
Number of pages23
JournalCritical Reviews in Oncology/Hematology
Volume142
DOIs
StatePublished - Oct 1 2019

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Keywords

  • Antiemetic
  • Chemotherapy-induced nausea and vomiting
  • Efficacy
  • Palonosetron
  • Safety

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Geriatrics and Gerontology

Cite this

Chow, R., Aapro, M., Navari, R. M., Gralla, R. J., Chiu, N., Chiu, L., Chan, S., Popovic, M., Lam, H., Lock, M., & DeAngelis, C. (2019). Do we still need to study palonosetron for chemotherapy-induced nausea and vomiting? A cumulative meta-analysis. Critical Reviews in Oncology/Hematology, 142, 164-186. https://doi.org/10.1016/j.critrevonc.2019.07.017