Tablets control vomiting in chemotherapy patients
Studies suggest drug can effectively replace IV
Chemotherapy patients experience debilitating nausea as a side effect of treatment. Traditionally, physicians have prescribed intravenous (IV) antiemetics for cancer patients undergoing moderately and highly emetogenic chemotherapy. However, results from two large studies comparing the effectiveness of oral and IV antiemetics show that granisetron hydrochloride [produced by SmithKline Beecham in Philadelphia under the brand name Kytril] is as effective as IV therapy while offering substantial cost savings and improvements in quality of life.
"It costs an estimated $270 for a single IV dose of 32 mg of the antiemetic ondansetron, compared to $63 for a single dose of Kytril, " says Edith A. Perez, MD, a clinician and researcher with the Mayo Clinic in Jacksonville, FL, lead researcher on one of two studies comparing IV therapy with Kytril recently presented at the annual meeting of the American Society of Clinical Oncology in Alexandria, VA.
In addition, the IV dose takes about 30 minutes to deliver. "The tablet is more convenient, as well," Perez says. "I believe using the tablet represents financially responsible, quality medical care. In practical terms, we can see the patient in the clinical setting, determine what type of chemotherapy he needs, and by the time the pharmacist finishes mixing the chemotherapy, the tablet has already done its job. There is no delay in treatment while we wait for IV administration of an antiemetic."
Researchers conducted two separate doubleblind, randomized multicenter studies comparing Kytril tablets with IV ondansetron. The first study included patients undergoing highly emetogenic chemotherapy with cisplatin. The second study included patients undergoing moderately emetogenic chemotherapy with cyclophosphamide and carboplatin. In addition, the first study assessed the effectiveness of antiemetics 24 hours after chemotherapy. The second study assessed effectiveness of antiemetics at both 24 and 48 hours after chemotherapy.
In the first study, 1,054 patients received either two 1 mg Kytril tablets, or 32 mg of IV ondansetron prior to an initial course of cisplatin. The study found that the total control rate, defined as no nausea or vomiting and no additional medication, at 24 hours was 55% for patients receiving Kytril tablets compared with 58% for patients receiving IV ondansetron.
In the second study, 1,085 patients received either two 1 mg Kytril tablets or 32 mg of IV ondansetron prior to an initial course of cyclophosphamide or carboplatin. The total control rate at 24 hours was 59% for patients receiving Kytril tablets compared with 58% for patients receiving IV ondansetron. The total control rate at 48 hours was 47% for patients receiving Kytril and 44% for patients receiving IV therapy.
Side effects for patients receiving Kytril in both studies included headache and constipation. Ondansetron-treated patients experienced a higher incidence of dizziness and visual disturbances.
Although Kytril tablets have been available in the United States since 1995, most physicians continue to prescribe IV ondansetron for chemotherapy patients. "These results are very important for chemotherapy patients," says Perez. "Kytril tablets offer patients comparable efficacy with the convenience of a tablet, yielding increased convenience and both time and financial savings."
[Editor’s note: For more information about Kytril tablets, contact: SmithKline Beecham at (800) 366-8900, or via the Internet at http://www.sb.com.]
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content