Anti-emetic control with ondansetron in the chemotherapy of breast cancer: a review.

Nausea and vomiting are significant problems in patients receiving outpatient chemotherapy for breast cancer. Three, randomised, double-blind studies comparing the efficacy and safety of ondansetron with placebo in patients receiving 14-day CMF (Study 1), and with metoclopramide in patients receiving FAC/FEC (Study 2) or EC (Study 3) are reviewed. Ondansetron was superior to placebo in Study 1; complete control of emesis (0 emetic episodes) over 15 days was achieved in 62% of ondansetron-treated patients compared to 34% of placebo-treated patients (P = 0.02). Ondansetron was also superior to metoclopramide in Study 2, with complete control of emesis in 66% of patients given ondansetron and 27% on metoclopramide. Complete plus major control of emesis (0-2 emetic episodes) also significantly favoured ondansetron (86% vs 42%; P less than 0.001). In Study 3, complete control of emesis was obtained in 60% of patients given ondansetron and 47% given metoclopramide, complete plus major control being obtained in 72% and 61% for the respective treatments. The difference, however, was not statistically significant (P = 0.230). In Study 2, which was of a crossover design, significantly more patients expressed a preference for ondansetron (63% vs 26%; P = 0.001). Ondansetron was safe and well tolerated.