Can Granisetron Injection Used as Primary Prophylaxis Improve the Control of Nausea and Vomiting with Low- Emetogenic Chemotherapy?

Abstract

<b>Background:</b> The purpose of this study is to examine the risk of uncontrolled chemotherapy-induced nauseaand vomiting (CINV) among patients receiving low emetogenic chemotherapy (LEC) with and without granisetroninjection as the primary prophylaxis in addition to dexamethasone and metochlopramide. Materials and <br/><b>Methods</b>:This was a single-centre, prospective cohort study. A total of 96 patients receiving LEC (52 with and 42 withoutgranisetron) were randomly selected from the full patient list generated using the e-Hospital Information System(e-His). The rates of complete control (no CINV from days 1 to 5) and complete response (no nausea or vomitingin both acute and delayed phases) were identified through patient diaries which were adapted from the MASCCAntiemesis Tool (MAT). Selected covariates including gender, age, active alcohol consumption, morning sicknessand previous chemotherapy history were controlled using the multiple logistic regression analyses. <br/><b>Results</b>: Bothgroups showed significant difference with LEC regimens (p<0.001). No differences were found in age, gender,ethnic group and other baseline characteristics. The granisetron group indicated a higher complete response ratein acute emesis (adjusted OR: 0.1; 95%CI 0.02-0.85; p=0.034) than did the non-granisetron group. Both groupsshowed similar complete control and complete response rates for acute nausea, delayed nausea and delayedemesis. <br/><b>Conclusions</b>: Granisetron injection used as the primary prophylaxis in LEC demonstrated limited rolesin CINV control. Optimization of the guideline-recommended antiemetic regimens may serve as a less costlyalternative to protect patients from uncontrolled acute emesis.