Is a dexamethasone-sparing strategy capable of preventing acute and delayed emesis caused by combined doxorubicin and paclitaxel for breast cancer? Analysis of a phase II trial

Silvia Damian, Luigi Celio, Elena De Benedictis, Paola Mariani, Francesco Agustoni, Francesca Ricchini, Filippo De Braud

Research output: Contribution to journalArticle


Objective: The effectiveness of palonosetron without delayed dexamethasone dosing against emesis was investigated in patients scheduled to receive the corticosteroid-containing combination of doxorubicin and paclitaxel (AT) for 3 cycles. Methods: Chemo-naïve women with breast cancer receiving doxorubicin (60 mg/m2) and paclitaxel (200 mg/m2) were eligible. Patients received palonosetron 0.25 mg intravenously before chemotherapy, however, all patients also received a premedication consisting of prednisone (25 mg orally the evening before therapy) and hydrocortisone (250 mg intravenously just before paclitaxel). The primary end point was complete control (CC; no vomiting, no rescue anti-emetics, and no more than mild nausea) during the overall phase (days 1-5) following cycle 1. Results: Seventy-six patients were enrolled and evaluable (median age 50 years). Fifty-six patients (74%; 95% CI 62-83%) achieved overall CC. Acute (day 1) and delayed (days 2-5) CC rates were 78 and 74%, respectively. No vomiting rates for the acute, delayed and overall phases were 85, 85 and 83%, respectively. An exploratory analysis showed only a small decrease in the probability of achieving CC between cycle 1 (74%) and cycle 3 (66%). Conclusion: The dexamethasone-sparing strategy prevented emesis in more than 70% of breast cancer patients receiving their initial cycle of AT chemotherapy.

Original languageEnglish
Pages (from-to)371-377
Number of pages7
Issue number6
Publication statusPublished - Jun 2013



  • Breast cancer
  • Chemotherapy-induced nausea and vomiting
  • Dexamethasone
  • Doxorubicin
  • Emesis
  • Paclitaxel
  • Palonosetron

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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