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Efficacy of palonosetron-based antiemetic prophylaxis in breast cancer patients receiving anthracycline-containing adjuvant chemotherapy: A survey in 41 German gyneco-oncology prac...

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Zeitschriftentitel: Journal of Clinical Oncology
Personen und Körperschaften: Schilling, Joerg Peter, Klare, Peter, Wetzel, Antje, Kittel, Kornelia, Hindenburg, Hans-Joachim, Gazawi, Nidal, Jungberg, Peter, Guth, Dagmar, Busch, Steffi, Geberth, Matthias, Konias, Marina, Ortner, Petra Angelika, Feyer, Petra C.
In: Journal of Clinical Oncology, 30, 2012, 15_suppl, S. e19540-e19540
Format: E-Article
Sprache: Englisch
veröffentlicht:
American Society of Clinical Oncology (ASCO)
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Zusammenfassung: <jats:p> e19540 </jats:p><jats:p> Background: The emesis risk in young breast cancer (BC) patients (pts) receiving adjuvant anthracyclines (A) plus cyclophosphamide (C), taxanes or other cytotoxics is higher than anticipated earlier. Furthermore, antiemetic control seems to decline in subsequent cycles of chemotherapy (CT). The ASCO has classified AC to be highly emetogenic (HEC) in their antiemetic guidelines 2011. Palonosetron (P) is a 5-HT3-receptor-antagonist (5-HT3-RA) with higher receptor affinity and longer biological half-life than older compounds. Data suggest that Palonosetron is clinically more effective in the acute phase and that in contrast to the older 5-HT3-RA it is also effective in the delayed phase. P also showed to maintain its efficacy in subsequent cycles. Current antiemetic guidelines list palonosetron as preferred 5-HT3-RA in moderate emetogenic chemotherapy (MEC). Methods: To evaluate the efficacy of palonosetron after 4 cycles of A containing chemotherapy in BC patients, we have conducted a survey in 41 practices of the BNGO in Germany. Between Nov 2007 and Jan 2012 1299 patients have been documented. Median age was 55 years. Severity, frequency, duration and onset of N/V were recorded in a patient diary. Efficacy criteria were complete control CC (no V, no rescue, mild N); complete response (CR: no V, no rescue) and rescue medication. Results: At the beginning P was used as single agent (56%). Following the MASCC 2010 guidelines P was used in combination with dexamethasone (PDex, 15%) or plus dex and NK1-RA (PNDex, 23%), 16% of pts received additional medication. Efficacy after 4 cycles of CT: Overall (5 days): Complete control CC: (no V, no rescue, mild N) 63,3% of pts, complete response (CR: no V, no rescue) 73,7%; Rescue Medication was needed in 15,6% of pts. PDex CC 48,7%, CR 69,8 %, PNDex: CC 76,3%, CR % 83,33. N was also very well controlled: Overall (5 days) 56% of pts no nausea, 15% moderate N 3% severe N. Conclusions: Palonosetron in combination with dex and NK1-RA is very effective to control nausea and vomiting in A-based adjuvant chemotherapy in young breast cancer patients after 4 cycles of chemotherapy. </jats:p>
Umfang: e19540-e19540
ISSN: 0732-183X
1527-7755
DOI: 10.1200/jco.2012.30.15_suppl.e19540