Do we still need to study palonosetron for chemotherapy-induced nausea and vomiting? A cumulative meta-analysis.

Abstract

INTRODUCTION:

The aim is to conduct an updated systematic review comparing palonosetron to other 5-HT3RAs for the prophylaxis of CINV, assess for publication biases, and determine whether further RCTs are required, that could potentially lead to a different meta-conclusion.

METHODS:

Random-effects analysis model was used to generate odds ratio (OR), risk differences (RD) and accompanying 95% confidence intervals (CI). Funnel plots to assess for biases and cumulative meta-analyses to assess effect size over time were generated.

RESULTS:

4145 patients were randomized to palonosetron and 4911 received other 5-HT3RAs. In the majority of efficacy endpoints, the meta-conclusion has not changed over time - recent clinical trials simply narrow CIs the meta-conclusion. Safety profile boasts a stable conclusion over time. No publication biases exist.

CONCLUSION:

Considering the vast amount of resources needed to conduct RCTs, resources should be dedicated to other prophylactic treatments/settings which have not been as well explored.

• Authors: Ronald Chow, Matti Aapro, Rudolph M Navari, Richard Gralla, Nicholas Chiu, Leonard Chiu, Stephanie Chan, Marko Popovic, Henry Lam, Michael Lock, Carlo DeAngelis
• Journal: Critical reviews in oncology/hematology (Crit Rev Oncol Hematol) Vol. 142 Pg. 164-186 (Oct 2019) ISSN: 1879-0461 [Electronic] Netherlands
• PMID: 31419719 (Publication Type: Comparative Study, Journal Article, Meta-Analysis)
• Copyright: Copyright © 2019. Published by Elsevier B.V.

Chemical References

• Antiemetics
• Antineoplastic Agents
• Serotonin 5-HT3 Receptor Antagonists
• Palonosetron

Topics

• Antiemetics (therapeutic use)
• Antineoplastic Agents (adverse effects, therapeutic use)
• Humans
• Nausea (chemically induced, prevention & control)
• Neoplasms (drug therapy)
• Odds Ratio
• Palonosetron (therapeutic use)
• Serotonin 5-HT3 Receptor Antagonists (therapeutic use)
• Vomiting (chemically induced, prevention & control)