Meta-analysis of palonosetron for prevention of delayed chemotherapy-induced nausea and vomiting in pediatric patients

Chemotherapy-induced nausea and vomiting (CINV) are common adverse events in patients undergoing emetogenic chemotherapy. Palonosetron is a second-generation 5-hydroxytryptamine-3 receptor antagonist (5-HT3 RA) with a long half-life. Researchers at Hokkaido University (Sapporo, Japan) undertook a meta-analysis of published studies comparing palonosetron versus first-generation 5-HT3 RAs) for prevention of delayed CINV in pediatric patients. Meta-analysis of four randomized controlled trials showed that for the endpoint of complete response (no emesis and no rescue medication) palonosetron was superior to first-generation 5-HT3 RAs (RR 1.21; p<0.01). No publication bias was observed in the funnel plots. The CR rate for overall (RR 1.25; p=0.04) and acute CINV (RR 1.06; p=0.03) was also significantly higher for palonosetron. The authors conclude that palonosetron is effective in the prophylaxis of delayed CINV in pediatric patients.