For cancer patients undergoing chemotherapy that includes cisplatin, the combination of two drugs is better than one for curbing acute cisplatin-induced nausea and vomiting, a Korean study suggests.

Cisplatin is one of the most effective chemotherapy drugs available but it is notorious for causing nausea and vomiting, which could reduce compliance with treatment.

Both the anti-nausea agent ramosetron and the corticosteroid dexamethasone have been shown to reduce nausea vomiting when given separately to patients undergoing cisplatin-containing chemotherapy regimens. However, the combined anti-emetic effects of these two agents have not been studied, until now.

To investigate, researchers enrolled 34 patients with solid tumors in a crossover study in which ramosetron plus dexamethasone or ramosetron alone was administered during one cycle each of cisplatin-based chemotherapy.

Dr. Yoon-Koo Kang from the University of Ulsan College of Medicine in Seoul, and colleagues found that the two-drug combo was statistically superior to ramosetron alone in terms of controlling acute nausea and vomiting.

The authors originally intended to enroll 70 patients, but an interim analysis showing significant differences in efficacy led to early discontinuation of the trial.

In light of the improvement, the researchers conclude, it is “highly recommended that a combination of ramosetron plus dexamethasone rather than ramosetron alone should be given to prevent cisplatin-induced acute emesis.”

SOURCE: Clinical Drug Investigation March 2005.