Rationale for the use of a single fixed intravenous dolasetron dose for the prevention of cisplatin-induced nausea and vomiting: Pooled analysis of 14 clinical trials Journal Article


Authors: Whitmore, J. B.; Kris, M. G.; Hesketh, P. J.; Grote, T. H.; DuBois, D. M.; Cramer, M. B.; Hahne, W. F.
Article Title: Rationale for the use of a single fixed intravenous dolasetron dose for the prevention of cisplatin-induced nausea and vomiting: Pooled analysis of 14 clinical trials
Abstract: Dolasetron mesilate is a selective 5-HT3 receptor antagonist that prevents chemotherapy-induced and postoperative nausea and vomiting. For the majority of patients in intravenous dolasetron trials for chemotherapy- induced nausea and vomiting, dosing has been based on body weight (mg/kg). The approved weight-based dose is 1.8 mg/kg based on results of controlled clinical trials. However, trials of dolasetron evaluating oral doses for prevention of chemotherapy-induced emesis, and intravenous doses for prevention and treatment of postoperative emesis have used a fixed milligram dose. To identify an appropriate intravenous fixed milligram dose for the prevention of chemotherapy-induced nausea and vomiting, this analysis was performed to derive efficacy results for fixed milligram doses from pooled results obtained with dosing based on body weight. Intravenous dolasetron doses for 1,598 patients treated on a mg/kg basis (0.3, 0.6, 1.2, 1.8, 2.4, 3.0 and 5.0 mg/kg) in 14 clinical trials were converted to fixed milligram doses based on weight. Fixed-dose groups were established at doses of 50, 75, 100, 125, 150, and 200 mg. Doses less than or equal to the midpoint between two dose groups were included in the lower dose group. Pooled results showed that the 100 mg intravenous dolasetron dose group (who received actual doses of 88-112 mg) produced the highest rate (53%) of complete response (0 emetic episodes and no rescue medication in the 24-h period following initiation of chemotherapy).
Keywords: adolescent; adult; cancer chemotherapy; human tissue; aged; middle aged; human cell; major clinical study; clinical trial; cisplatin; dose response; antineoplastic agents; neoplasms; nausea; vomiting; drug administration schedule; body weight; dose-response relationship, drug; serotonin antagonist; antiemetics; indoles; meta analysis; intravenous drug administration; injections, intravenous; dose time effect relation; dolasetron mesilate; humans; prognosis; human; male; female; priority journal; article; quinolizines; chemotherapy-induced nausea and vomiting; antiemetic
Journal Title: Supportive Care in Cancer
Volume: 6
Issue: 5
ISSN: 0941-4355
Publisher: Springer Verlag  
Date Published: 1998-08-01
Start Page: 473
End Page: 478
Language: English
DOI: 10.1007/s005200050197
PUBMED: 9773466
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 12 December 2016 -- Source: Scopus
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  1. Mark Kris
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