Kim Jeong Eun, Hong Yong Sang, Lee Jae-Lyun, Kim Kyu-Pyo, Park Seong Joon, Sym Sun Jin, Shin Dong Bok, Lee Jeeyun, Park Young Suk, Ahn Jin Seok, Kim Tae Won
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil Songpa-gu, Seoul, 138-736, South Korea.
Support Care Cancer. 2015 Jun;23(6):1769-77. doi: 10.1007/s00520-014-2507-6. Epub 2014 Dec 3.
The granisetron transdermal system (GTS) showed non-inferior efficacy to oral granisetron to control chemotherapy-induced nausea and vomiting (CINV) during multiday chemotherapy. We compared the efficacy and safety of GTS with that of intravenous and oral granisetron in Korean patients receiving moderately emetogenic chemotherapy (MEC).
A total of 276 patients were randomized into GTS (n = 139, one patch on days 1-4) or control group (n = 137, intravenous on day 1 and oral on days 2-4). The primary endpoint was the percentage of patients achieving complete response (CR) from chemotherapy initiation until 24 h after the final administration.
Out of 234 patients (112 in GTS and 122 in control group) included in the per protocol analysis, 97.9 % had gastrointestinal cancer and 76.9 % received 3-day chemotherapy. The GTS showed non-inferior efficacy achieving CR in 75.0 % of the patients; 74.6 % of the patients in the control group achieved CR (95 % confidence interval -10.73 to 11.55 %). The CR rate did not change after subgroup analyses by sex, age, and chemotherapy naivety and analysis per day and overall days of treatment. The GTS group showed sustained CR from day 1 to day 4. Patients' satisfaction, assessed using Functional Living Index-Emesis (FLI-E), showed no difference. Both treatments were well tolerated and safe.
The GTS showed non-inferior efficacy to intravenous and oral granisetron. The safety, tolerability, and FLI-E scores of the GTS were comparable to those of control group. The GTS offers a convenient alternative option for relieving CINV in patients receiving MEC.
在多日化疗期间,格拉司琼透皮系统(GTS)在控制化疗引起的恶心和呕吐(CINV)方面显示出与口服格拉司琼非劣效的疗效。我们比较了GTS与静脉注射和口服格拉司琼在接受中度致吐性化疗(MEC)的韩国患者中的疗效和安全性。
总共276例患者被随机分为GTS组(n = 139,第1 - 4天贴一片)或对照组(n = 137,第1天静脉注射,第2 - 4天口服)。主要终点是从化疗开始至最后一次给药后24小时达到完全缓解(CR)的患者百分比。
在意向性分析纳入的234例患者(GTS组112例,对照组122例)中,97.9%患有胃肠道癌,76.9%接受了3天化疗。GTS显示出非劣效的疗效,75.0%的患者达到CR;对照组74.6%的患者达到CR(95%置信区间 -10.73至11.55%)。按性别、年龄和初次化疗情况进行亚组分析以及按治疗天数和总治疗天数分析后,CR率没有变化。GTS组从第1天到第4天持续保持CR。使用功能性生活指数 - 呕吐(FLI - E)评估的患者满意度没有差异。两种治疗耐受性良好且安全。
GTS在疗效上与静脉注射和口服格拉司琼非劣效。GTS的安全性、耐受性和FLI - E评分与对照组相当。GTS为接受MEC的患者缓解CINV提供了一种方便的替代选择。