Oral combination antiemetics in patients with small cell lung cancer receiving cisplatin or cyclophosphamide plus doxorubicin

L. B. Cleri, M. G. Kris, L. B. Tyson, K. M W Pisters, R. A. Clark, Richard J. Gralla

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background. Intravenous antiemetic combinations containing a 5-HT3 receptor antagonist (like metoclopramide, ondansetron, or granisetron) with dexamethasone have become the standard therapy for the treatment of acute chemotherapy-induced vomiting. Intravenous antiemetics, however, can be more costly and take more time to prepare and deliver, and therefore are not preferred for home, outpatient, or office use. The objective of this study was to determine the antiemetic activity and safety of the oral combination antiemetic regimen of metoclopramide, dexamethasone, and diphenhydramine in patients with small cell lung cancer receiving standard outpatient chemotherapy programs. Methods. Fifty-two patients receiving initial cisplatin (60 mg/m2) or cyclophosphamide (600-1500 mg/m2) plus doxorubicin (30-45 mg/m2) received an oral regimen of metoclopramide (3 mg/kg x 2 then 2 mg/kg x 2 or 4 doses), dexamethasone (20 mg) and diphenhydramine (50 mg x 2 or 3 doses) (oral MDD), beginning 30 minutes before chemotherapy. Results. Vomiting was prevented in 15 of 21 (76%) patients (95% confidence interval [CI], 53%-92%) receiving cisplatin and 21 of 31 (71%) individuals (95% CI, 52%86%) given cyclophosphamide plus doxorubicin. Adverse effects were mild and transient and included sedation, loose stools, akathisia, and hiccoughs. Conclusions. The oral MDD antiemetic regimen prevented acute emesis in 73% of the patients entered and was well tolerated in this population of patients with small cell lung cancer.

Original languageEnglish (US)
Pages (from-to)774-778
Number of pages5
JournalCancer
Volume76
Issue number5
DOIs
StatePublished - 1995
Externally publishedYes

Fingerprint

Antiemetics
Small Cell Lung Carcinoma
Doxorubicin
Cyclophosphamide
Cisplatin
Metoclopramide
Dexamethasone
Vomiting
Diphenhydramine
Drug Therapy
Outpatients
Hiccup
Granisetron
Confidence Intervals
Serotonin 5-HT3 Receptor Antagonists
Receptors, Serotonin, 5-HT3
Ondansetron
Psychomotor Agitation
Safety
Therapeutics

Keywords

  • antiemetics
  • dexamethasone
  • diphenhydramine
  • doxorubicin
  • metoclopramide
  • nausea
  • v omiting

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Oral combination antiemetics in patients with small cell lung cancer receiving cisplatin or cyclophosphamide plus doxorubicin. / Cleri, L. B.; Kris, M. G.; Tyson, L. B.; Pisters, K. M W; Clark, R. A.; Gralla, Richard J.

In: Cancer, Vol. 76, No. 5, 1995, p. 774-778.

Research output: Contribution to journalArticle

Cleri, L. B. ; Kris, M. G. ; Tyson, L. B. ; Pisters, K. M W ; Clark, R. A. ; Gralla, Richard J. / Oral combination antiemetics in patients with small cell lung cancer receiving cisplatin or cyclophosphamide plus doxorubicin. In: Cancer. 1995 ; Vol. 76, No. 5. pp. 774-778.
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abstract = "Background. Intravenous antiemetic combinations containing a 5-HT3 receptor antagonist (like metoclopramide, ondansetron, or granisetron) with dexamethasone have become the standard therapy for the treatment of acute chemotherapy-induced vomiting. Intravenous antiemetics, however, can be more costly and take more time to prepare and deliver, and therefore are not preferred for home, outpatient, or office use. The objective of this study was to determine the antiemetic activity and safety of the oral combination antiemetic regimen of metoclopramide, dexamethasone, and diphenhydramine in patients with small cell lung cancer receiving standard outpatient chemotherapy programs. Methods. Fifty-two patients receiving initial cisplatin (60 mg/m2) or cyclophosphamide (600-1500 mg/m2) plus doxorubicin (30-45 mg/m2) received an oral regimen of metoclopramide (3 mg/kg x 2 then 2 mg/kg x 2 or 4 doses), dexamethasone (20 mg) and diphenhydramine (50 mg x 2 or 3 doses) (oral MDD), beginning 30 minutes before chemotherapy. Results. Vomiting was prevented in 15 of 21 (76{\%}) patients (95{\%} confidence interval [CI], 53{\%}-92{\%}) receiving cisplatin and 21 of 31 (71{\%}) individuals (95{\%} CI, 52{\%}86{\%}) given cyclophosphamide plus doxorubicin. Adverse effects were mild and transient and included sedation, loose stools, akathisia, and hiccoughs. Conclusions. The oral MDD antiemetic regimen prevented acute emesis in 73{\%} of the patients entered and was well tolerated in this population of patients with small cell lung cancer.",
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T1 - Oral combination antiemetics in patients with small cell lung cancer receiving cisplatin or cyclophosphamide plus doxorubicin

AU - Cleri, L. B.

AU - Kris, M. G.

AU - Tyson, L. B.

AU - Pisters, K. M W

AU - Clark, R. A.

AU - Gralla, Richard J.

PY - 1995

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N2 - Background. Intravenous antiemetic combinations containing a 5-HT3 receptor antagonist (like metoclopramide, ondansetron, or granisetron) with dexamethasone have become the standard therapy for the treatment of acute chemotherapy-induced vomiting. Intravenous antiemetics, however, can be more costly and take more time to prepare and deliver, and therefore are not preferred for home, outpatient, or office use. The objective of this study was to determine the antiemetic activity and safety of the oral combination antiemetic regimen of metoclopramide, dexamethasone, and diphenhydramine in patients with small cell lung cancer receiving standard outpatient chemotherapy programs. Methods. Fifty-two patients receiving initial cisplatin (60 mg/m2) or cyclophosphamide (600-1500 mg/m2) plus doxorubicin (30-45 mg/m2) received an oral regimen of metoclopramide (3 mg/kg x 2 then 2 mg/kg x 2 or 4 doses), dexamethasone (20 mg) and diphenhydramine (50 mg x 2 or 3 doses) (oral MDD), beginning 30 minutes before chemotherapy. Results. Vomiting was prevented in 15 of 21 (76%) patients (95% confidence interval [CI], 53%-92%) receiving cisplatin and 21 of 31 (71%) individuals (95% CI, 52%86%) given cyclophosphamide plus doxorubicin. Adverse effects were mild and transient and included sedation, loose stools, akathisia, and hiccoughs. Conclusions. The oral MDD antiemetic regimen prevented acute emesis in 73% of the patients entered and was well tolerated in this population of patients with small cell lung cancer.

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