The efficacy of tropisetron in the control of chemotherapy induced emesis in children with cancer

3. SUMMARY We evaluated the antiemetic efficacy of tropisetron, a 5-hydroxytriptamine (5 HT3) receptor antagonist, in terms of control of acute emesis during grade 3 or 4 emetogenic chemotherapy in children. Tropisetron was administered as a single intravenous dose of 0.2 mg/kg in the first day and intravenously or orally with the same dose on subsequent days. A total of 125 courses of highly emetogenic chemotherapy was administered to 22 children with a median age of 14 years (range: 3-18 years). Most of the children had not received previous anticancer chemotherapy (82%). All 22 patients received tropisetron for at least two courses. Corticosteroids were part of the chemotherapy regimen in 13 courses (10 %) and part of the premedication protocol for hypersensitivity reactions in 10 courses (8 %). Overall complete response on day 1 was observed in 80 out of 125 courses (64 %). The response rates were consistent over multiple courses; a complete and major response rate on the first day of Course I (n: 22 courses) and Course II (n: 22 courses) was observed in 73 % and 77 % respectively. When the results were analysed according to the daily-schedules, overall complete response for grade 4, grade 3 and grade 1-2 emetogenic group was 59 %, 85 % and 75 % respectively. No side effects of tropisetron other than mild diarrhea and a sensation of dry-mouth was documented in this study. In conclusion, the results of this study confirmed that tropisetron is a safe, good tolerable and effective antiemetic drug for the prevention of acute emesis in children and adolescents who are receiving high emetogenic chemotherapy. A single daily dose seems to be an advantage for both the patient and the physician.