Petru, E., Andel, J., Angleitner-Boubenizek, L., Steger, G., Bernhart, M., Busch, K., … Zabernigg, A. (2008). Early Austrian multicenter experience with palonosetron as antiemetic treatment for patients undergoing highly or moderately emetogenic chemotherapy. Wiener Medizinische Wochenschrift, 158(5–6), 169–173.

To evaluate the efficacy of palonosetron in the clinical practice setting

Patients were given premedication with 0.25 mg palonosetron on day one of each chemotherapy cycle. All patients were prescribed standard antiemetics as recommended in Multinational Association of Supportive Care in Cancer (MASCC) and American Society of Clinical Oncology (ASCO) guidelines. Patients completed questionnaires to document satisfaction with control of nausea and emesis in the acute and delayed phases.

• The study consisted of 135 participants.
• Age of patients was not provided.
• The majority of patients were female (67%).
• Patients had a variety of cancer diagnoses, with the most frequently being breast, lung, and ovarian; 67% of patients had metastatic disease.
• The majority of patients were receiving cisplatin, carboplatin, anthracyclines, 5-floururacil, or cyclophosphamide.
• One-fifth of patients reported anticipatory nausea, and 19% of patients were chemotherapy naïve.
• Patients were receiving either moderately or highly emetogenic treatments.

The study was conducted in multiple outpatient settings in Austria.

All patients were in active treatment.

This was a prospective trial.

• Patients reported their satisfaction with antiemetic control on a four-point Likert-type scale.
• Complete response (CR) was defined a lack of emesis and no rescue medications used on days 1–5 of chemotherapy.

• The overall CR rate was 68%, with 87% on day 1, and 72% on days 2–5.
• Response rates were highest in males (82%), those age 50 or older (70%–73%), and those who were chemotherapy naïve (73%) (p < 0.05).
• Subgroup analysis showed that the CR rate also was lower in patients who received highly emetogenic therapy.
• Nausea was highest on days 2 and 3. Palonsetron side effects including vertigo and dyspepsia were reported by 1.5% of patients.

Palonosetron was found to be effective for prevention of chemotherapy-induced nausea and vomiting (CINV) and to provide a significant contribution to the antiemetic armamentarium.

• An appropriate control group was not included.
• Actual measurement of nausea was not provided.
• Method of measurement of emesis episodes or use of rescue medications was not described.

Findings support the effectiveness of palonosetron in management of CINV. Effectiveness in managing nausea, rather than just emesis, is not clear.