tropisetron and Melanoma

In this double-blind, randomized trial performed at five study centers, the prophylactic, antiemetic effect of two different dosages of tropisetron (Navoban; Sandoz Pharma Ltd, Basel, Switzerland) was investigated in dacarbazine-treated patients with melanoma. Patients received tropisetron 5 mg or 10 mg orally (as one capsule) once daily (minimum 3 days) on each day of chemotherapy. No significant differences were found in the effects of tropisetron 5 mg and 10 mg. During the first 24 hours, total control of vomiting was seen in 93% and 98% of patients receiving tropisetron 5 mg and 10 mg, respectively. Total control of nausea was achieved in 84% and 80% of patients receiving tropisetron at these dosages. Over days 2 to 7 of chemotherapy, total control of vomiting and nausea remained high. Patients reported that quality of life remained good throughout chemotherapy, as did mood; only a small decrease in food intake occurred. Tropisetron was well tolerated. Constipation was the most common adverse event, occurring in 13% of patients. Headache (4%), diarrhea (4%), and anorexia (2%) also were observed.

Topics: Administration, Oral; Adult; Aged; Antiemetics; Antineoplastic Agents; Dacarbazine; Double-Blind Method; Drug Administration Schedule; Female; Humans; Indoles; Male; Melanoma; Middle Aged; Nausea; Quality of Life; Serotonin Antagonists; Tropisetron; Vomiting

Topics: Antiemetics; Apoptosis; Down-Regulation; Humans; Melanoma; Molecular Docking Simulation; NF-kappa B; Ondansetron; Paclitaxel; Serotonin; Tropisetron; Vomiting

Fixed drug eruptions (FDEs) represent an uncommon subset of drug reactions where typically dusky red skin eruptions recur at the same site each time a drug is administered. Multifocal FDEs are defined by skin eruptions at more than one site. We describe a patient with metastatic melanoma who developed a multifocal FDE to paracetamol, tropisetron and ondansetron during chemoimmunotherapy with interleukin 2 (IL-2) and dacarbazine. This case is unique since to our knowledge there has been no previous report of such a drug reaction to tropisetron. Moreover, recurrences were induced by drugs which were chemically unrelated (i.e. tropisetron and paracetamol). We propose that this unusual skin reaction to multiple drugs was induced by IL-2 administered during immunochemotherapy for the metastatic melanoma.

Topics: Acetaminophen; Adult; Analgesics, Non-Narcotic; Antiemetics; Drug Eruptions; Drug Interactions; Humans; Indoles; Interleukin-2; Melanoma; Ondansetron; Skin; Tropisetron