Improved control of high-dose-cisplatin-induced acute emesis with the addition of prochlorperazine to granisetron/dexamethasone

Paul J. Hesketh, David R Gandara, Ann M. Hesketh, Martin Edelman, Lauri M. Webber, Matthew McManus, John D. Hainsworth

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


PURPOSE: To evaluate the antiemetic efficacy and safety of adding the dopamine antagonist prochlorperazine to the combination of granisetron and dexamethasone in the prevention of acute nausea and vomiting following high- dose cisplatin. PATIENTS AND METHODS: Sixty patients receiving cisplatin (≤ 75 mg/m2) (median dose = 100 mg/m2) were enrolled at three sites. Patients received prochlorperazine spansule 15 mg orally, 60 minutes prior to and 12 hours after cisplatin; dexamethasone 20 mg intravenously, 45 minutes prior to cisplatin, and 10 mg intravenously or orally, 12 hours after cisplatin; and granisetron 10 μg/kg intravenously, 30 minutes prior to cisplatin. Efficacy was assessed during the 24-hour period after cisplatin using complete antiemetic response (no emetic episodes and no rescue antiemetics) and patient assessment of nausea and satisfaction using 100-mm visual analog scales (nausea: 0 = none, 100 = nausea as bad as it can be; satisfaction: 0 = not at all satisfied, 100 = satisfied as can be). RESULTS: Complete response (0 emetic episodes) was noted in 84% (49/58) of patients. Forty-two patients (72%) experienced no nausea. The mean change in posttreatment nausea visual analog scales from baseline was 8.9 mm. Forty-eight patients (83%) were completely satisfied with their antiemetic treatment. The mean posttreatment patient satisfaction score was 92 mm. Treatment was well tolerated, with infrequent and minor adverse events. CONCLUSIONS: This three-drug antiemetic regimen is well tolerated and highly effective in the prevention of acute nausea and vomiting arising from high-dose cisplatin. Further studies evaluating this regimen are warranted.

Original languageEnglish (US)
Pages (from-to)180-183
Number of pages4
JournalCancer Journal from Scientific American
Issue number3
StatePublished - 1997


  • 5-hydroxytryptamine receptor antagonists
  • Antiemetics
  • cisplatin
  • dexamethasone
  • granisetron
  • prochlorperazine

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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