In a new study of patients with gynecologic cancer receiving chemoradiation, the use of transdermal granisetron showed promising results in controlling late-onset chemotherapy-induced nausea and vomiting (CINV) symptoms during the first treatment cycle. The study’s results were published in Supportive Care in Cancer.
This prospective study examined 75 patients’ responses to either transdermal granisetron (41) or oral ondansetron (34) in controlling CINV. Administration of transdermal granisetron involved a skin patch given weekly. Ondansetron was given during the 72 hours following chemotherapy in patients who received it.
Patients received radiation with cisplatin for cervical (61 cases), endometrial (12 cases), or vaginal (2 cases) cancer, and were treated for up to 5 cycles. For assessing CINV symptoms, phases following each treatment were defined as acute (first day), delayed (24 to 72 hours), or late (after 72 hours). Complete response (CR) included the absence of emesis or retching and the avoidance of rescue antiemetic medications.
During the late phase of cycle 1, CR was reported for 49.8% (95% CI, 35.2%-64.3%) of patients receiving transdermal granisetron. For the oral ondansetron group, the CR rate was 39.7% (95% CI, 24.4%-56.1%). The researchers reported an 82% probability of greater success in controlling late-onset CINV symptoms with transdermal granisetron than with oral ondansetron.
Patients receiving transdermal granisetron utilized antiemetic rescue therapies at statistically higher rates than did patients on the oral ondansetron arm throughout the acute phases of cycles 2 and 3. At other times, the treatment groups experienced CINV events at similar rates. Quality of life and medication compliance metrics were also similar for both groups.
“Our study provides support for transdermal granisetron as another option for patients who are at high risk for CINV and are at risk for noncompliance with oral antiemetic alternatives,” the researchers stated in their report.
Armbruster SD, Fellman BM, Jhingran A, et al. A phase III study of transdermal granisetron versus oral ondansetron for women with gynecologic cancers receiving pelvic chemoradiation [published online April 27, 2020]. Support Care Cancer. doi:10.1007/s00520-020-05484-z