Improved control of emesis and quality of life with ondansetron in breast cancer.

Cyclophosphamide-based chemotherapy is often given to patients for the treatment of breast cancer. This chemotherapy can induce severe nausea and vomiting in these patients, which can adversely affect their quality of life, especially as these regimens are often given on an outpatient basis over several courses. This paper reviews 5 randomised, double-blind, multicenter comparative studies which have been carried out in breast cancer patients to evaluate the efficacy and safety profile of the potent and highly selective 5-HT3 receptor antagonist, ondansetron. These studies have shown that ondansetron is superior to placebo in the control of emesis induced by a 14-day CMF schedule and that it is superior to conventional anti-emetics (metoclopramide and alizapride) in the control of acute and delayed emesis induced by regimens containing high-dose cyclophosphamide. Ondansetron was well tolerated in these studies and did not induced any extrapyramidal reactions. The efficacy and tolerability of ondansetron was reflected in a better quality of life for patients given this anti-emetic which was formally assessed in 2 of the studies using the Rotterdam Symptom Checklist or the Functional Living Index-Emesis. In conclusion, ondansetron is an effective and well-tolerated anti-emetic for patients receiving cyclophosphamide-based chemotherapy for the treatment of breast cancer. Ondansetron provides significant benefits for patients' quality of life compared with conventional anti-emetics particularly as these patients are often treated on an outpatient basis and can be treated with oral ondansetron at home.