COMPARISON OF THE ANTIEMETIC EFFICACY OF GRANISETRON AND ALIZAPRIDE PLUS DEXAMETHASONE FOR CHEMOTHERAPY

In a randomized single-blind international multicentre trial, two antiemetic regimens were compared in 115 oncology patients undergoing chemotherapy for the first time (cisplatin > 15 mg/m2, or ifosfamide > 1200 mg/m2 or etoposide > 120 mg/m2). One group received granisetron, a 5-hydroxytryptamine type-3-receptor antagonist, 40-mu-g/kg alone intravenously before chemotherapy, with, if necessary, up to two further doses daily of 40-mu-g/kg. The second group received a combination of alizapride plus dexamethasone (4 mg/kg alizapride and 8 mg/kg dexamethasone before chemotherapy, repeated, if necessary, after 4 and 8 hours up to two additional doses). There was good antiemetic efficacy (a maximum of one episode of vomiting in 24 hours = >>major efficacy<<) in 50 of 62 patients (80.7%) in the granisetron group, and in 37 out of 53 (69.8%) of those treated with alizapride and dexamethasone; failure of antiemetic therapy occurred in 4.8% (granisetron) and 15.1% (combination) of patients. For the first day of each 5-day chemotherapy cycle, there was a higher rate of excellent antiemetic efficacy (no or only mild nausea, and no vomiting) with granisetron (90.3% vs 69.8%, P < 0.006). The frequency (29% vs 32%) and nature of side effects (obstipation, diarrhoea, headaches, anxiety, vertigo), the causes of which were not differentiated, were similar. No extrapyramidal reactions occurred with granisetron. Of the 62 patients treated with granisetron, 47 did not require any further granisetron after the single daily prophylactic dose.