Comparison of tropisetron (ICS 205-930) with alizapride plus dexamethasone in the prevention of emesis induced by repeated cisplatin administration

Tropisetron (ICS 205-930), a new 5-hydroxytryptamine (5-HT₃) receptor antagonist, was compared with alizapride combined with dexamethasone-21-phosphate (DEXA) in the prevention of emesis induced by chemotherapeutic regimens containing high-dose cisplatin (CDDP). Forty patients were randomised to receive tropisetron (n = 20) or the comparison treatment (n = 20) administered during two consecutive cycles. CDDP was given on Day 1 of both chemotherapy cycles to 11 patients in each group and for two to four consecutive days to the remaining patients. The patients received tropisetron (5 mg/day iv) or alizapride (300 mg/day iv) plus DEXA (16-32 mg/day iv) on each day of CDDP administration, followed by oral tropisetron (5 mg/day) or alizapride (300 mg/day) for two consecutive days. Tropisetron was more effective than alizapride plus DEXA in the prevention of nausea and vomiting induced by CDDP, the difference being more pronounced for Day 1 of both chemotherapy cycles. The antiemetic effect of tropisetron was slightly inferior in six patients given CDDP for three to four consecutive days. In all patients tropisetron was better tolerated than alizapride and DEXA; the side effects of the latter were more frequent and severe and required therapeutic intervention more often.