Ng, W., & Della-Fiorentina, S. (2010). The efficacy of oral ondansetron and dexamethasone for the prevention of acute chemotherapy-induced nausea and vomiting associated with moderately emetogenic chemotherapy—A retrospective audit. European Journal of Cancer Care, 19, 403–407. 

To determine the efficacy of 8 mg oral ondansetron plus 8 mg oral dexamethasone as prechemotherapy antiemetic regimen for patients receiving moderately emetogenic chemotherapy (MEC)

Patients who received treatment with MEC were given a standard oral regimen of 8 mg ondansetron and 8 mg dexamethasone. Patients were instructed to take these medications one hour prior to their scheduled treatments. Nursing staff assessed compliance prior to chemotherapy treatment. Nursing staff assessed each patient on day one after chemotherapy treatment.

• The study consisted of 81 participants.
• Mean age was 54 years with a range of 32–80 years.
• The sample was 65% female and 35% male.
• All participants were patients with cancer receiving moderately emetogenic chemotherapy (MEC).
• Cancer diagnoses were breast (48%), lung (25%), colorectal (23%), and gynecologic (4%).
• The sample was composed of 53% patients receiving adjuvant chemotherapy and 47% patients being treated with palliative intention.
• The most frequent chemotherapy regimens were anthracycline (48%) and carboplatin-based (28%).

The study was conducted at a single, outpatient site in Australia.

Study participants were in active treatment, receiving palliative care.

This was a retrospective, descriptive audit.

Common Terminology Criteria for Adverse Events (CTAE v3.0) was used to measure severity of acute nausea and vomiting.

• The 8 mg of oral ondansetron plus 8 mg oral dexamethasone regimen achieved control of acute emesis in 75% of all patients and control of acute nausea in 44% of the patients.
• Patients treated with anthracycline-based chemotherapy had a significantly higher incidence of both acute emesis (90% versus 59%; p = 0.001) and nausea (67% versus 21%; p < 0.001) when compared with those who received nonanthracycline-based chemotherapy.

The use of 8 mg oral ondansetron and 8 mg oral dexamethasone as antiemetics for MEC offers comparable efficacy to other regimens for control of acute emesis; however, this regimen does not adequately control acute nausea, particularly in anthracycline-based regimens.

• Retrospective data audit did not have available data on use of rescue medications in the first 24 hours following chemotherapy.
• Data was descriptive only.

Although 8 mg oral ondansetron and 8 mg oral dexamethasone provided adequate rates of relief of acute CINV in nonanthracycline-based chemotherapy regimens, they alone are not adequate for anthracycline-based regimens.