CC BY-NC-ND 4.0 · South Asian J Cancer 2014; 03(02): 132-137
DOI: 10.4103/2278-330X.130466
SOUTH ASIAN UPDATE : Original Article

Ramosetron hydrochloride for the prevention of cancer chemotherapy induced nausea and vomiting: The Indian experience

Jayesh J. Sanmukhani
Department of New Product Development, Cadila Healthcare Ltd., Ahmedabad, Gujarat, India
,
Prafulla Pawar
Department of New Product Development, Cadila Healthcare Ltd., Ahmedabad, Gujarat, India
,
Ravindra Mittal
Department of New Product Development, Cadila Healthcare Ltd., Ahmedabad, Gujarat, India
› Author Affiliations
Source of Support: Nill.

Abstract

Background: Despite the advent of 5-HT 3 antagonists, control of delayed gastrointestinal adverse events with cancer chemotherapy is still not optimal. This open label, active controlled, multicentric clinical trial was undertaken to assess the comparative efficacy and safety of ramosetron with ondansetron for the prevention of acute and delayed nausea and vomiting associated with emetogenic cancer chemotherapy in adult patients in India. Materials and Methods: Enrolled patients received treatment with ramosetron hydrochloride 0.1 mg or ondansetron hydrochloride 4 mg tablets once daily in the morning for 5 days starting 1 h before the start of chemotherapy. Severity grades of nausea and vomiting were recorded on a daily basis for a period of 5 days and complete response rate (CRR) and effective rate (ER) were calculated. Clinical adverse events were recorded and hematological and biochemical investigations were performed for safety assessment. Results: A total of 114 patients in ramosetron group and 100 patients in ondansetron group completed the study and were eligible for efficacy and safety analysis. CRR and ERs show that while ramosetron is non-inferior to ondansetron in the control of early nausea and vomiting (occurring during the first 24 h) after the treatment with emetogenic chemotherapy, it is superior to ondansetron in the control of delayed nausea and vomiting (occurring after the first 24 h). The proportion of patients achieving a cumulative complete response (for the entire study period) is significantly greater in ramosetron group as compared to ondansetron group (27.2% vs. 7.0%; P < 0.001). Ramosetron was well tolerated by all the study participants. Conclusions: Ramosetron is significantly more effective than ondansetron for the control of delayed nausea and vomiting induced by emetogenic cancer chemotherapy.



Publication History

Article published online:
31 December 2020

© 2014. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Carelle N, Piotto E, Bellanger A, Germanaud J, Thuillier A, Khayat D. Changing patient perceptions of the side effects of cancer chemotherapy. Cancer 2002;95:155-63.
  • 2 Grunberg SM, Deuson RR, Mavros P, Geling O, Hansen M, Cruciani G, et al. Incidence of chemotherapy-induced nausea and emesis after modern antiemetics. Cancer 2004;100:2261-8.
  • 3 Hickok JT, Roscoe JA, Morrow GR, King DK, Atkins JN, Fitch TR. Nausea and emesis remain significant problems of chemotherapy despite prophylaxis with 5-hydroxytryptamine-3 antiemetics: A University of Rochester James P. Wilmot Cancer Center Community Clinical Oncology Program Study of 360 cancer patients treated in the community. Cancer 2003;97:2880-6.
  • 4 de Wit R. Current position of 5HT3 antagonists and the additional value of NK1 antagonists; a new class of antiemetics. Br J Cancer 2003;88:1823-7.
  • 5 Rabasseda X. Ramosetron, a 5-HT3 receptor antagonist for the control of nausea and vomiting. Drugs Today (Barc) 2002;38:75-89.
  • 6 Nasea OD. Tablets 0.1 mg [package insert]. Tokya, Japan: Astellas Pharma Inc.; 2007.
  • 7 Nasea Injections 0.3 mg [package insert]. Tokya, Japan: Astellas Pharma Inc.; 2007.
  • 8 Astellas Pharma Inc., Tokyo. Astellas Launches Irribrow® for the Treatment of Irritable Bowel Syndrome. Available from: http://www.astellas.com/en/corporate/news/pdf/081006_eg.pdf. [Last cited on 2013 Aug 01].
  • 9 National Cancer Institute: Cancer Therapy Evaluation Program Maryland. Common Terminology Criteria for Adverse Events (CTCAE) and Common Toxicity Criteria (CTC). Available from http://www.ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/ctcaev3.pdf. [Last cited on 2013 Aug 01].
  • 10 Ho CL, Su WC, Hsieh RK, Lin ZZ, Chao TY. A randomized, double-blind, parallel, comparative study to evaluate the efficacy and safety of ramosetron plus dexamethasone injection for the prevention of acute chemotherapy-induced nausea and vomiting. Jpn J Clin Oncol 2010;40:294-301.
  • 11 Jordan K, Sippel C, Schmoll HJ. Guidelines for antiemetic treatment of chemotherapy-induced nausea and vomiting: Past, present, and future recommendations. Oncologist 2007;12:1143-50.
  • 12 Kris MG, Hesketh PJ, Somerfield MR, Feyer P, Clark-Snow R, American society of clinical oncology guideline for antiemetics in oncology: Update 2006. J Clin Oncol 2006;24:2932-47.
  • 13 Shi Y, He X, Yang S, Ai B, Zhang C, Huang D, et al. Ramosetron versus ondansetron in the prevention of chemotherapy-induced gastrointestinal side effects: A prospective randomized controlled study. Chemotherapy 2007;53:44-50.
  • 14 Noda K, Ikeda M, Taguchi T, Kanamaru R. Clinical assessment of ramosetron hcl oral preparation in the treatment of nausea and vomiting induced by cisplatin: A multicenter, randomized, parallel-design, double-blind comparative study with ondansetron HCl. Curr Ther Res 2002;63:636-48.
  • 15 Cheirsilpa A, Sinthusake T, Songsakkaesorn A, Visawaprasit S, Chulaka K, Changkuingdee N. Comparison of ramosetron and granisetron for the prevention of acute and delayed emesis in Cisplatin-based chemotherapy: A randomized controlled trial. Jpn J Clin Oncol 2005;35:695-9.
  • 16 Yano S, Makino K, Nakamura H, Kai Y, Morioka M, Hamada J, et al. Comparative clinical study of the anti-emetic effects of oral ramosetron and injected granisetron in patients with malignant glioma undergoing ACNU chemotherapy. Neurol Med Chir (Tokyo) 2005;45:294-8.
  • 17 Feng FY, Zhang P, He YJ, Li YH. Comparison of the selective serotonin-3 antagonists Ramosetron and Granisetron in treating acute chemotherapy-induced emesis, nausea, and anorexia: A single-blind, randomized, crossover study. Curr Ther Res 2000;61:901-9.
  • 18 Koizumi W, Tanabe S, Nagaba S, Higuchi K, Nakayama N, Saigenji K, et al. A double-blind, crossover, randomized comparison of granisetron and ramosetron for the prevention of acute and delayed cisplatin-induced emesis in patients with gastrointestinal cancer: Is patient preference a better primary endpoint? Chemotherapy 2003;49:316-23.
  • 19 Kim K, Chie EK, Jang JY, Kim SW, Oh DY, Im SA, et al. Ramosetron for the prevention of nausea and vomiting during 5-fluorouracil-based chemoradiotherapy for pancreatico-biliary cancer. Jpn J Clin Oncol 2009;39:111-5.