Thalidomide for prevention of chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy

Geng Song, Nianfei Wang, Fanfan Li, Qian He


Antiemetic guidelines recommend co-administration of agents to maximize the prevention of chemotherapy-induced nausea and vomiting (CINV), however, the control of delayed CINV is still not satisfactory. The purpose of this study was to evaluate the effectiveness and safety of thalidomide in the prevention of CINV.

Of 89 patients enrolled, 83 chemotherapy-naïve patients receiving highly emetogenic chemotherapy (cisplatin 70mg/m2) were randomized into two groups: standard therapy group (ondansetron on day 1, metoclopramide and dexamethasone on days one to five) and thalidomide group (in addition to standard emesis prevention, patients received oral 100mg thalidomide on days one to five). Patients recorded nausea and vomiting episodes in a diary. The primary end point was the efficacy of thalidomide in controlling vomiting and nausea on days one to five post cisplatin, and the secondary end point was the safety of the thalidomide.

No significant differences of complete response rates (no emesis, no use of rescue therapy and no nausea) were observed between the two groups, while the percentages of patients with complete response of delayed vomiting on day four and day five were higher in the thalidomide group, furthermore, the complete response rate of delayed nausea for thalidomide group and standard therapy group showed significant differences. Thalidomide group showed a similar safety profile as standard emesis prevention group.

Addition of thalidomide was generally well tolerated and improved prevention of CINV in patients receiving cisplatin-based chemotherapy to some degree, especially for delayed nausea.
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