NEW YORK (Reuters Health) - A second-generation anti-nausea drug has advantages over its predecessor in preventing chemotherapy-induced nausea and vomiting, new research shows.

Some chemo regimens are highly likely to induce severe vomiting, both immediately and then 2-5 days later on (delayed phase).

The newer drug, palonosetron, is comparable to the older agent, granisetron, in preventing vomiting in the immediate phase, and superior to granisetron in the delayed phase, Dr. Mitsue Saito and colleagues report.

Their study, reported in the Lancet Oncology, involved 1143 patients who were randomly assigned to receive a single-dose of palonosetron or granisetron 30 minutes before chemo treatment.

The main outcome measures, Saito, from Juntendo University Hospital, Tokyo, and colleagues explain were the proportion of patients who experienced no vomiting episodes during the immediate phase (0 to 24 hours after chemotherapy) and delayed phase (24 to 120 hours after chemotherapy).

Vomiting in the early phase was completely prevented in 75.3 percent of patients given palonosetron and in 73.3 percent of those assigned to granisetron. During the delayed phase, the complete prevention rate was significantly higher in the palonosetron group than the granisetron group: 56.8 percent vs. 44.5 percent.

Constipation, the main treatment-related side effect, occurred in 17.4 percent and 15.7 percent of palonosetron-treated and granisetron-treated patients, respectively.

SOURCE: Lancet Oncology, online January 8, 2009.

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