• Systemic Treatment Disease Site Group. Use of 5-HT3 receptor antagonists in patients receiving moderately or highly emetogenic chemotherapy [full report]. Toronto (ON): Cancer Care Ontario (CCO); 2003 Jan [online update]. 24 p. (Practice guideline; no. 12-3). [49 references]

• Intravenous dolasetron, granisetron and ondansetron should be regarded as equally efficacious and well tolerated.
• As a first-line approach, 5-HT₃ receptor antagonists should be administered for 24 hours following chemotherapy.
• There are insufficient data to draw conclusions about the equivalence of the 5-HT₃ receptor antagonists when given orally. A single study comparing dolasetron and ondansetron suggests that a higher than recommended dose of oral dolasetron is at least as efficacious as oral ondansetron.

None provided

Original: March 2000

Twelve double-blind randomized controlled trials (RCTs) addressing the question of the relative efficacy and adverse effects of ondansetron, dolasetron and granisetron were eligible for inclusion in this guideline report. Nine additional double-blind randomized studies addressed the value of the administration of these agents beyond the first 24 hours.

An additional double-blind study, which randomized patients to receive either ondansetron or low-dose metoclopramide, was reviewed. Six studies of unblinded or single-blind design were identified and reviewed.

Update: January 2003

Two clinical practice guidelines, two meta-analyses, and four double-blind randomized controlled trials were identified in the update search and were eligible for review.

• Systemic Treatment Disease Site Group. Use of 5-HT3 receptor antagonists in patients receiving moderately or highly emetogenic chemotherapy [full report]. Toronto (ON): Cancer Care Ontario (CCO); 2003 Jan [online update]. 24 p. (Practice guideline; no. 12-3). [49 references]

Not applicable: The guideline was not adapted from another source.

2000 Mar 7 (updated online 2003 Jan)

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

The Practice Guidelines Initiative (PGI) is the main project of the Program in Evidence-based Care (PEBC), a Province of Ontario initiative sponsored by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

Cancer Care Ontario, Ontario Ministry of Health and Long-Term Care

Provincial Systemic Treatment Disease Site Group

Members of the Systemic Treatment Disease Site Group (DSG) disclosed potential conflict of interest information.

None available

This summary was completed by ECRI on July 19, 2002. The information was verified by the guideline developer on August 19, 2002. This summary was updated by ECRI on August 6, 2003. The updated information was verified by the guideline developer on September 2, 2003.