Hydration Requirements with Emetogenic Chemotherapy: Granisetron Extended-Release Subcutaneous Versus Palonosetron

Figures & data

Figure 1. Study design.

GERSC: Granisetron extended-release subcutaneous; HEC: Highly emetogenic chemotherapy; MEC: Moderately emetogenic chemotherapy.

Table 1. Patient demographics and baseline characteristics.

	Palonosetron only; n = 93	GERSC only; n = 91	Switched (palonosetron to GERSC); n = 48
Age; mean (min, max), years	65 (39, 90)	63 (32, 87)	65 (32, 84)
Sex; n (%)
Men	30 (32)	26 (29)	15 (31)
Women	63 (68)	65 (71)	33 (69)
Cancer type; n (%)
Breast	19 (20)	18 (20)	11 (23)
Bronchus or lung	29 (31)	22 (24)	5 (10)
Gastrointestinal	9 (10)	21 (23)	9 (19)
Genitourinary	4 (4)	2 (2)	1 (2)
Gynecologic	16 (17)	10 (11)	10 (21)
Leukemia/lymphoma	11 (12)	15 (17)	8 (17)
Other	5 (5)	3 (3)	4 (8)
NCCN emetogenicity; n (%)
HEC	78 (84)	55 (60)	32 (67)
MEC	15 (16)	36 (40)	16 (33)
Radiation therapy; n (%)
Yes	23 (25)	12 (13)	5 (10)
Antiemetic regimen	Palonosetron 0.25 mg iv. + fosaprepitant 150 mg iv. + dexamethasone 10 mg^†	GERSC 10 mg sc. + fosaprepitant 150 mg iv. + dexamethasone 10 mg^†	Palonosetron 0.25 mg iv. + aprepitant 150 mg iv. + dexamethasone 10 mg, then GERSC 10 mg sc. + aprepitant 150 mg + dexamethasone 10 mg^†

† Dexamethasone was administered on the same day as chemotherapy. Patients were also prescribed oral dexamethasone as needed.

GERSC: Granisetron extended-release subcutaneous; HEC: Highly emetogenic chemotherapy; iv.: Intravenous; max: Maximum; MEC: Moderately emetogenic chemotherapy; min: Minimum; NCCN: National Comprehensive Cancer Network; sc.: Subcutaneous.

Table 2. Group 1 analysis: number of chemotherapy cycles and hydration rate.

Treatment	Number of chemotherapy cycles		Hydration rate
	Mean (SD)	Median (min, max)	Mean (SD)	Median (min, max)
Total
Palonosetron (n = 93)	5.4 (2.8)	5.0 (1, 13)	0.9 (1.1)	0.6 (0, 5.6)
GERSC (n = 91)	4.1 (2.2)	4.0 (1, 10)	0.3 (0.6)*	0 (0, 2.7)
HEC
Palonosetron (n = 78)	5.6 (2.9)	6 (1, 13)	1.0 (1.2)	0.7 (0, 5.6)
GERSC (n = 55)	4.0 (2.1)	4 (1, 8)	0.3 (0.6)*	0 (0, 2.7)
MEC
Palonosetron (n = 15)	4.3 (1.5)	4 (2, 7)	0.5 (0.5)	0.3 (0, 1.5)
GERSC (n = 36)	4.1 (2.4)	4 (1, 10)	0.3 (0.5)	0 (0, 2.0)

*p < 0.0001 for the difference in hydration rate versus palonosetron.

GERSC: Granisetron extended-release subcutaneous; HEC: Highly emetogenic chemotherapy; max: Maximum; MEC: Moderately emetogenic chemotherapy; min: Minimum; SD: Standard deviation.

Figure 2. Group 1 analysis.

Distribution of hydration rate by chemotherapy cycle and by antiemetic regimen.

GERSC: Granisetron extended-release subcutaneous; PALO: Palonosetron.

Figure 3. Group 1 analysis.

Distribution of hydration rates by chemotherapy cycle and by antiemetic regimen for patients receiving (A) highly emetogenic chemotherapy or (B) moderately emetogenic chemotherapy.

GERSC: Granisetron extended-release subcutaneous; PALO: Palonosetron.

Table 3. Group 2 analysis: number of chemotherapy cycles and hydration rate (switched patients).

Treatment	Number of chemotherapy cycles		Hydration rate
	Mean (SD)	Median (min, max)	Mean (SD)	Median (min, max)
Total
Palonosetron (n = 48)	3.5 (3.2)	2.0 (1, 13)	0.6 (1.1)	0.2 (0, 5.3)
GERSC (n = 48)	3.1 (2.2)	3.0 (1, 11)	0.5 (1.1)	0 (0, 5.0)
HEC
Palonosetron (n = 32)	3.3 (3.1)	2.0 (1, 13)	0.7 (1.2)	0.2 (0, 5.3)
GERSC (n = 32)	2.9 (2.0)	2.5 (1, 9)	0.5 (1.0)*	0 (0, 5.0)
MEC
Palonosetron (n = 16)	3.9 (3.3)	3.0 (1, 11)	0.5 (0.9)	0.2 (0, 3)
GERSC (n = 16)	3.7 (2.7)	3.5 (1, 11)	0.6 (1.3)	0 (0, 5)

*p = 0.028 for the difference in hydration rate versus palonosetron.

GERSC: Granisetron extended-release subcutaneous; HEC: Highly emetogenic chemotherapy; max: Maximum; MEC: Moderately emetogenic chemotherapy; min: Minimum; SD: Standard deviation.