Monday, August 8, 2011

Breast Cancer News (8/8): Aloxi for nausea

Nausea and vomiting are perhaps the most unpleasant potential side-effects of chemotherapy to treat breast cancer. This year, several studies have shown Aloxi (palonosetron) to be effective in the prevention of chemotherapy-induced nausea and vomiting for breast cancer patients. All of the studies discussed today may be found on the Aloxi page of the website.

Single dose of Aloxi plus dexamethasone for moderately emetogenic chemotherapy

A May 2011 study in the Italian journal Tumori examined the effectiveness of Aloxi to control nausea and vomiting associated with moderately emetogenic chemotherapy, meaning chemotherapy with a moderate risk of vomiting. A single IV administration of Aloxi (.25 mg) plus dexamethasone (8 mg) before the administration of chemotherapy adequately controlled nausea and vomiting "during the entire period of emetic risk."

Aloxi plus dexamethasone for repeated cycles of Platinol, AC or EC chemotherapy

An August 2011 Japanese phase III study in Supportive Care in Cancer tested Aloxi with repeated cycles of Platinol (highly emetogenic), Adriamycin/Cytoxan (AC) and Ellence/Cytoxan (EC) chemotherapy combinations. Aloxi (.75 mg) was administered 30 minutes prior to chemotherapy. Dexamethasone was administered on days 1 through 3. The authors found an "extraordinary safety profile and maintenance of efficacy . . . throughout repeated chemotherapy cycles."

Two studies show Aloxi to be superior to other, similar drugs

Biologically, Aloxi is a 5-hydroxytryptamine receptor antagonist (5-HT(3) RA). It blocks the action of seratonin at 5-HT(3) receptors in the central nervous system and gastrointestinal tract. Other 5-HT(3) RAs are available for the supression of nausea and vomiting. Two recent studies found Aloxi to be superior to other 5-HT(3) RAs.

A May study in Supportive Care in Cancer compared Aloxi to other 5-HT(3) RAs in breast cancer patients treated with Cytoxan based chemotherapy and lung cancer patients on Paraplatin (carboplatin) or Platinol (cisplatin). The patients on Aloxi had a "significantly lower risk" of nausea and vomiting associated with hospital admission compared to those treated with other 5-HT(3) RAs.

Similarly, a June 2011 study in Expert Reviews of Pharmacoeconomics & Outcomes Research compared different 5-HT RAs in combination with aprepitant/fosaprepitant and dexamethasone for highly emetogenic chemotherapy. Patients on Aloxi had a lower risk of uncontrolled nausea and vomiting events than patients on other 5-HT(3) RAs.

At, we'll continue to add the latest news and research on medications to treat side effects to our database and website. Please stay tuned.

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