Prevention of cisplatin-induced delayed emesis: still unsatisfactory. Italian Group for Antiemetic Research.

The incidence of and prognostic factors in cisplatin-induced delayed emesis were evaluated in 522 naive cancer patients. They each received an intravenous combination of ondansetron and one of four different doses of dexamethasone for the prevention of acute emesis and a combination of orally administered metoclopramide plus intramuscular dexamethasone for the prevention of delayed emesis. Despite the best prophylaxis for acute and delayed emesis, 37.4%/57.1% of patients experienced delayed vomiting/nausea. The presence of acute vomiting/nausea was the main prognostic factor in delayed vomiting/nausea; therefore, a multifactorial analysis of the results achieved during the delayed phase adjusted for those obtained during the acute phase should be carried out in every study evaluating the efficacy of different antiemetic drugs for delayed emesis.