ESMO Asia Virtual Congress 2020

Abstract 343P

Background

Palonosetron was greater than first-generation 5-HT₃ receptor antagonists in the prevention of nausea and vomiting have been established in many systematic reviews. However, several recent randomized control trials manifested inconsistent results. Thus, we conducted a systematic review to evaluate the efficacy and safety of palonosetron versus granisetron in chemotherapy induced nausea and vomiting (CINV).

Methods

The PubMed, Embase, and The Cochrane Library databases were searched for studies published before April 2020. The meta-analysis was performed to estimate the pooled effect sizes by using a random effect model. The primary outcome was treatment responses of CINV (complete response rate, complete control rate, and total control rate). Secondary outcomes were 5-HT₃ receptor antagonist related common side effects (constipation, and headache).

Results

Twelve randomized controlled trials, three prospective studies and one retrospective study were reviewed. Palonosetron was consistently statistically superior in any phase of complete response rate (acute phases: odds ratio [OR]= 1.37, 95% confidence interval [CI]: 1.03 to 1.82; delayed phases: OR= 1.57, 95% CI: 1.15 to 2.15; overall phases: OR= 1.37, 95% CI: 1.17 to 1.60), delayed phases of complete control rate and total control rate (OR= 1.45, 95% CI: 1.23 to 1.72; OR= 1.29, 95% CI: 1.01 to 1.65, respectively). Subgroup analysis indicated that there was no significant difference between palonosetron and granisetron in any phase of complete response when combined with NK₁ antagonists. No statistically significant difference was found between constipation and diarrhea toxicities of the two groups.

Conclusions

Although palonosetron significantly decreased the risk of chemotherapy induced nausea and vomiting in any phase, granisetron is seeming comparable effectiveness with palonosetron when adding NK₁ antagonists.