tropisetron and Breast-Neoplasms

Three patients, two females aged 45 and 56 years with metastasized breast carcinoma and one man aged 88 years with inoperable bronchial carcinoma, suffered from severe pruritus. This was only alleviated after treatment with paroxetine, a serotonin re-uptake inhibitor, or with tropisetron, a serotonin antagonist. The youngest woman then could be given chemotherapy, after which clinical recovery occurred, the other patients died, one week and 3 months, respectively, after start of the treatment. Pruritus is a relatively rare symptom in malignancies, but may be worse than pain. In the development and transmission of pruritus signals, in cholestatic icterus as well, serotonin appears to play a more important part than histamine.

Topics: Aged; Aged, 80 and over; Breast Neoplasms; Carcinoma, Bronchogenic; Cholestasis; Diagnosis, Differential; Fatal Outcome; Female; Humans; Indoles; Lung Neoplasms; Male; Middle Aged; Paroxetine; Pruritus; Selective Serotonin Reuptake Inhibitors; Serotonin Antagonists; Treatment Outcome; Tropisetron

Perioperative multimodal analgesia can prevent chronic pain after breast cancer surgery. This study aimed to investigate the efficacy of combined perioperative oral pregabalin and postoperative esketamine in preventing chronic pain after breast cancer surgery.. Ninety patients undergoing elective breast cancer surgery were randomized into the combined pregabalin and esketamine group (EP group) and the general anesthesia alone group (Control group). The EP group received 150 mg of oral pregabalin 1 h before surgery and twice daily for seven days postoperatively, and a patient-controlled analgesia pump after surgery that delivered 100 μg sufentanil + 1.25 mg/kg esketamine + 4 mg tropisetron in 100 mL saline solution intravenously. The Control group received placebo capsules before and after the surgery and routine postoperative analgesia (100 μg sufentanil + 4 mg tropisetron in 100 mL saline solution). The primary outcome was the incidence of chronic pain three and six months after surgery. Secondary outcomes included acute postoperative pain, postoperative opioid consumption, and incidence of adverse events.. The incidence of chronic pain in the EP group was significantly lower than in the Control group three (14.3% vs 46.3%,. Combined perioperative oral pregabalin and postoperative esketamine effectively prevented chronic pain after breast cancer surgery, improved acute postoperative pain, and reduced postoperative opioid consumption.

Topics: Analgesics, Opioid; Breast Neoplasms; Chronic Pain; Female; Humans; Pain, Postoperative; Pregabalin; Saline Solution; Sufentanil; Tropisetron

Navoban (import tropisetron hydrochloride) can effectively prevent chemotherapy-induced nausea and vomiting; however, it is too expensive to be used extensively in clinic. This study was designed to compare the antiemetic efficacies and side effects of China-made tropisetron hydrochloride with Navoban.. A multicenter and randomized controlled trial was carried out. A total of 132 cancer patients were randomized into 2 groups and received 5 mg of China-made tropisetron hydrochloride (group A, 66 patients) or Navoban (group B, 66 patients) intravenously before cisplatin- or adriamycin-based chemotherapy. The gastrointestinal reactions induced by chemotherapy and side effects of the antiemetics were recorded within 7 days after chemotherapy.. Acute nausea was prevented completely in 48.5% of the patients in group A and in 43.8% of group B; acute vomiting was prevented completely in 69.7% of the patients in group A and in 67.2% of group B. Delayed nausea was prevented completely in 25.8% of the patients in group A and in 28.1% of group B; delayed vomiting was prevented completely in 47.0% of the patients in group A and in 51.6% of group B. No significant differences in complete control of nausea and vomiting showed between group A and group B (P > 0.05). Both antiemetic regimens were well tolerated, and no difference in adverse events between the 2 groups was observed (P > 0.05).. China-made tropisetron hydrochloride is as effective as Navoban in the prevention of chemotherapy-induced nausea and vomiting, and only causes mild, infrequent side effects.

Topics: Adult; Antiemetics; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Cisplatin; Doxorubicin; Female; Humans; Indoles; Lung Neoplasms; Male; Middle Aged; Nausea; Tropisetron; Vomiting, Anticipatory

We studied tropisetron (T) in patients with breast cancer receiving standard adjuvant chemotherapy with CEF (cyclophosphamide, epirubicin and 5-fluorouracil) over 3 consecutive cycles; T was administered alone or in combination with dexamethasone (D) or alprazolam (A). 50 women entered and during the 1st cycle patients received T i.v. before chemotherapy and the same dose orally on each of the following 3 days. In the 2nd cycle, T was administered together with D and during the 3rd cycle, T was combined with A and continued with T over the ensuing 3 days post-chemotherapy. Stress was present in 23 women and was evaluated for its impact on antiemetic response. Differences in the emetogenic response were found for nausea and vomiting mainly with the addition of A. The combination of T+A was superior to T and T+D in acute emesis (P<0.001). Concerning delayed emesis, differences were detected with both T+D and T+A (being equally effective) and superior to T alone (P<0.001). The emetogenic potential was decreased by the addition of A in comparison to T alone (P=0.001). Patients without stress had no difference, while patients with stress had a significantly better antiemetic result with the addition of D or A to T. In conclusion, T provides a satisfactory result in controlling nausea and emesis caused by moderately emetogenic CT regimens. Addition of D or A improves the antiemetic effect, and A provides better coverage in women with stress, a finding worth exploration in larger confirmatory studies.

Topics: Adult; Alprazolam; Antiemetics; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Cyclophosphamide; Dexamethasone; Epirubicin; Female; Fluorouracil; Humans; Indoles; Middle Aged; Tropisetron

While the use of 5-HT3 receptor antagonists is clearly justified in patients receiving cisplatin, their role with less emetic drugs is still not defined. The aim of our randomized study was to verify the efficacy of the single standard dose of three 5-HT3-receptor-antagonists in moderately emetic chemotherapies. Sixty chemotherapy-naive breast cancer patients of 30 to 71 years in age, P.S. = 0-1, receiving 5-fluorouracil-epirubicin-cyclophosphamide (FEC 75) q 21 days or cyclophosphamide-methotrexate-5-fluorouracil (CMF) or 120 mg/m2 epirubicin or high dose mitomycin-methotrexate-mitoxantrone (MMM) q 14 days (+ G-CSF) or 100 mg/m2 epirubicin (+ G-CSF) were randomized to receive, 15 min before chemotherapy, 8 mg i.v. bolus of ondansetron or 3 mg i.v. granisetron or 5 mg i.v. tropisetron and no further antiemetic therapy in the following days. 180 cycles were evaluable. Complete protection, (the absence of vomiting episodes,) was respectively 75%, 70% and 70% in the acute and 70%, 82%, 72% in the delayed phases, and an absence of nausea was 56%, 37% and 20% in the acute phase and 50%, 35% and 27% in the delayed, respectively. Complete response, (absence of vomiting and absence or mild nausea,) was 74%, 58.6% and 50.8% in the acute and 64%, 63.7%, 47.3% in the delayed phases, respectively. At the statistical analysis no significant differences between the three drugs were found regarding acute vomiting while ondansetron was superior to granisetron and tropisetron in acute (p = 0.018; p < 0.05) and delayed nausea (P = 0.104; p < 0.01). This activity is practically the same as that we reported (Ann Oncol 1994; 6, suppl 8: 204) with a loading dose on day 1 and maintenance for the following 2-5 days, but with a significantly favorable cost-benefit ratio.

Topics: Adolescent; Adult; Aged; Antiemetics; Antineoplastic Agents; Breast Neoplasms; Cisplatin; Cost-Benefit Analysis; Cyclophosphamide; Epirubicin; Female; Fluorouracil; Granisetron; Granulocyte Colony-Stimulating Factor; Humans; Indoles; Injections, Intravenous; Methotrexate; Middle Aged; Ondansetron; Serotonin Antagonists; Tropisetron; Vomiting

Thirty patients receiving cisplation or non-cisplatin (containing cyclophosphamide and adriamycin) chemotherapy were enrolled in a randomized, crossover study comparing the efficacy of single dose of Navoban (tropisetron, 5 mg) and Kytril (granisetron, 3 mg). The effective control of acute vomiting induced by cisplatin was achieved in 95.2% (20/21) of patients receiving Navoban and 90.5% (19/21) in those receiving Kytril. Complele control rate was 71.4% (15/21) in Navoban arm, and 81.0% (17/21) in Kytril arm. Total control of delayed vomiting (day 2-5) was 71.4%-90.4% in Navoban arm, while it was 66.7%-4% in Kytril arm. The effective control of vomiting induced by non-cisplatin drugs was achieved in 9/9 in both arms. It is concluded that both agents are effective in the control of vomiting induced by chemotherapy. They have identical adverse effects and are well tolerated by the patients.

Topics: Adult; Aged; Antiemetics; Antineoplastic Agents; Breast Neoplasms; Cisplatin; Female; Granisetron; Humans; Indoles; Lung Neoplasms; Lymphoma; Male; Middle Aged; Tropisetron; Vomiting

Neurotransmitters had progressive effects on various cancers via their different type of receptors.. This study was conducted to determine the pattern of serotonin receptors, respectively, 5HTR2A and 5HTR3A gene expression in MCF-7 cells and evaluate their selective antagonist effects on them.. RT-PCR was performed to determine the pattern of serotonin receptor gene expression in human breast cancer cell line (MCF-7). MCF-7 cells were cultured and treated via different doses of tropisetron (5HTR3A antagonist) and ketanserin (5HTR2A antagonist) for 48 hours. Oxidative and reductive enzyme activity was carried out by MTT assay. Subsequently, nuclear morphology of cells was observed by mixed dye florescent staining. To validate cell proliferation inhibition, Real time PCR was carried out for determining the descending rate of proliferating cell nuclear antigen (PCNA) gene expression in treating MCF-7 cells. Assessment of quantification of apoptosis and its discrimination with necrosis at single cell level using Flowcytometry technique was performed.. Results showed that 5HTR2A and 5HTR3A have expression in MCF-7 cells. Based on our finding, tropisetron and ketanserin had suppression effects on MCF-7 cells proliferation. (93.35% in tropisetron 50 µmoll(-1) and 72.36% in Ketanserin 25µmoll(-1) concentration).. Therefore, the use of tropisetron and ketanserin as an antagonist of serotonin receptor may be as new approaches are recommended for the treatment of breast cancer cells.

Topics: Antineoplastic Agents; Apoptosis; Breast Neoplasms; Gene Expression; Humans; Indoles; Ketanserin; MCF-7 Cells; Receptor, Serotonin, 5-HT2A; Receptors, Serotonin, 5-HT3; Serotonin 5-HT2 Receptor Antagonists; Serotonin 5-HT3 Receptor Antagonists; Tropisetron

Cutaneous adverse drug reactions (CADR) during chemotherapy are not rare, but difficult to manage. Case 1, a 49-year-old man was treated with 5-fluorouracil, irinotecan, and oxaliplatin for a pancreatic tumour. He developed a generalized urticaria during his seventh course of chemotherapy. 2 months later, skin tests determined a granisetron allergy with an ondansetron cross-reaction. Substituting the anti-emetic allowed continuation of the chemotherapy. Case 2, a 44-year-old woman, having recurring breast cancer that was treated with doxorubicin, and docetaxel developed a maculo-papular rash (MPR) the day after the first chemotherapy treatment. 2 weeks later, skin tests determined a corticosteroid class A allergy. Using a class C corticosteroid, no other reaction occurred. Case 3, a 44-year-old woman, having breast cancer treated with 5-fluorouracil, cyclophosphamide, and epirubicin developed an MPR after the second chemotherapy treatment. 12 days later, skin tests showed a granisetron allergy. Using alizapride, chemotherapy was continued with no further reaction. CADR necessitate a thorough investigation, modified according to the patient's chemotherapy treatment chronology and precautions while testing the molecules. Tests are rarely carried out, however, these tests allow for continuation of effective chemotherapy once the responsible agent has been determined. The 3 cases reported underline the role of complementary treatment and the necessity to test those molecules.

Topics: Adult; Antiemetics; Antineoplastic Agents; Breast Neoplasms; Cross Reactions; Drug Eruptions; Female; Glucocorticoids; Granisetron; Humans; Indoles; Male; Middle Aged; Ondansetron; Pancreatic Neoplasms; Prednisolone; Skin Tests; Tropisetron; Urticaria

Tropisetron is a novel selective antagonist of the type-3 serotonin (5-HT3) receptor, with proven efficacy in the control of emesis related to cancer treatment. Epirubicin in doses of > 100 mg/m2 has a high emetogenic potential. This study was designed to determine whether a single intravenous administration of tropisetron could prevent acute nausea and vomiting in patients treated with high dose epirubicin. Forty chemotherapy naive breast cancer patients treated with epirubicin at a dose of 110 mg/m2 on an outpatient basis were enrolled in the study. Tropisetron 5 mg i.v. was used as antiemetic prophylaxis. "On demand" treatment with tropisetron 5 mg p.os was used for the rescue of patients who failed on the initial i.v. dose. Complete control of acute nausea and vomiting had 62.5% (95% C.I. 47.2-77.8), partial control 15% (95% C.I. 3.8-26.2) and 22.5% (95% C.I. 9.3-35.7) insufficient control or failure. Headache was the most common adverse event reported in 3 patients (7.5%) and constipation in 2 patients (5%). Interestingly, patients with a negative experience of nausea and vomiting during pregnancy and those treated for metastatic disease, had a better control of chemotherapy-induced nausea and vomiting. In conclusion, a single 5 mg i.v. dose of tropisetron is safe and effective in preventing acute emesis in patients treated with high dose epirubicin.

Topics: Acute Disease; Adult; Aged; Antibiotics, Antineoplastic; Antiemetics; Breast Neoplasms; Chemotherapy, Adjuvant; Combined Modality Therapy; Constipation; Epirubicin; Female; Granulocyte Colony-Stimulating Factor; Headache; Humans; Indoles; Injections, Intravenous; Middle Aged; Nausea; Treatment Outcome; Tropisetron; Vomiting

Efficacy and safety of the antiemetic agent Navoban (5HT3-receptor-antagonist Tropisetron) on cytostatic-induced emesis of breast cancers and gynecological cancers was tested in 28 female patients receiving a total of 127 chemotherapy courses containing high (cisplatin), moderate high (cyclophosphamid) or moderate (for example 5 FU) emetogenic cytostatic drugs. We studied antiemetic response rates of Navoban (5 mg/d) during the first 24 hours after administration of the chemotherapy as well as response rates of the "delayed nausea and emesis" (days 2-9 after chemotherapy). A complete response was observed in 103 chemotherapy courses (= 81.1%) during the first 24 hours after chemotherapy and in 93 courses (= 73.2%) for the "delayed emesis". Treatment failures (more than 5 vomiting episodes) during the first 24 hours were present in four courses and for the "delayed emesis" in 11 courses. The side effects of Navoban such as constipation, headache or tiredness were minimum. Therefore no patient refused to receive the necessary chemotherapy. Navoban is, with its single dose application, an effective therapeutic drug for the prevention of nausea and emesis in patients receiving a chemotherapy.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Chemotherapy, Adjuvant; Female; Genital Neoplasms, Female; Humans; Indoles; Middle Aged; Nausea; Palliative Care; Serotonin Antagonists; Tropisetron; Vomiting