Ondansetron plus dexamethasone: an effective combination in high-dose cisplatin therapy. The Italian Oncology Group for Clinical Research.

ABSTRACT

Ondansetron as a single agent has been shown to be superior to metoclopramide in the control of acute nausea and vomiting induced by high-dose cisplatin, complete or major control (0-2 emetic episodes) being achieved in 65-75% of patients. In an attempt to further improve efficacy in this group of patients, a randomised, double-blind, crossover study was carried out comparing ondansetron with ondansetron plus dexamethasone. Ondansetron was given as three intravenous doses (0.15 mg/kg) 2-hourly and dexamethasone as a single intravenous dose of 20 mg prior to cisplatin (median 70 mg/m2, range 50-120 mg/m2). Complete control of emesis was achieved in 91% of patients receiving the combination of ondansetron plus dexamethasone and in 64% of patients receiving ondansetron alone (P less than 0.001). Nausea was absent in 89% of patients receiving the combination and in 66% of patients receiving ondansetron alone (P less than 0.0025). Both treatments were well tolerated. The addition of a single dose of dexamethasone to ondansetron significantly improves the control of emesis and nausea compared to ondansetron monotherapy in patients receiving high-dose cisplatin.