Evaluation of efficacy of palonosetron versus ramosetron in patients receiving emetogenic chemotherapy


  • Zainab Ghazala Department of Pharmacology, KBNIMS, Kalaburagi, Karnataka, India
  • Prakash Kalshetty Department of Pharmacology, KBNIMS, Kalaburagi, Karnataka, India
  • Anuradha H. V. Department of Pharmacology, MS Ramaiah Medical College, Bangalore, Karnataka, India




Aprepitant, Chemotherapy induced nausea and vomiting, Dexamethasone, Moderately emetogenic chemotherapy, Palonosetron, Ramosetron


Background: Chemotherapy induced nausea and vomiting is the most distressing side effect of cancer chemotherapy. It can seriously impact patient’s quality of life, influence the adherence to chemotherapy and progression free survival causing a delay or refusal of potentially life-saving therapy. The objective of this study was to compare the efficacy of palonosetron with ramosetron in achieving complete response to the chemotherapy.

Methods: This was a prospective randomized open-label study conducted on 130 patients admitted in Medical Oncology ward of a Tertiary Care Hospitals, Bangalore, India. Patients were randomized to receive either palonosetron 0.25 mg or ramosetron 0.3 mg I.V. along with aprepitant and dexamethasone 30 minutes prior to chemotherapy and were followed up for a period of 5 days post chemotherapy. The observations such as number and severity of vomiting and nausea, the outcome was assessed at the end of 5 days. Pearson’s Chi-square test was used to demonstrate the difference between both the study groups with respect to various categorical data.

Results: The complete response rate in delayed phase was more significant in patients who received palonosetron than patients who received ramosetron (72.3% vs 50.8%). Total control was achieved in 38.5% patients with palonosetron as compared to 15.4% patients with ramosetron.

Conclusions: Palonosetron is more efficacious than ramosetron in controlling chemotherapy induced nausea and vomiting especially in delayed phase of emesis.


Ballatori E, Roila F, Ruggeri B, Betti M, Sarti S, Soru G, et al. The impact of chemotherapy-induced nausea and vomiting on health-related quality of life. Supportive Care Cancer. 2007;15(2):179-85.

Cohen L, Moor CA, Eisenberg P, Ming EE, Hu H. Chemotherapy-induced nausea and vomiting-incidence and impact on patient quality of life at community oncology settings. Supportive Care Cancer. 2007;15(5):497-503.

Hickok JT, Roscoe JA, Morrow GR, King DK, Atkins JN, Fitch TR. Nausea and emesis remain significant problems of chemotherapy despite prophylaxis with 5‐hydroxytryptamine‐3 antiemetics. Cancer. 2003;97(11):2880-6.

Grunberg SM, Deuson RR, Mavros P, Geling O, Hansen M, Cruciani G, et al. Incidence of chemotherapy‐induced nausea and emesis after modern antiemetics: perception versus reality. Cancer: Interdisciplinary Inter J Am Cancer Soc. 2004;100(10):2261-668.

Grunberg SM, Osoba D, Hesketh PJ, Gralla RJ, Borjeson S, Rapoport BL, et al. Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity-an update. Supportive Care Cancer. 2005;13(2):80-4.

Navari RM, Province PS. Emerging drugs for chemotherapy-induced emesis. Expert Opinion Emerging Drugs. 2006;11(1):137-51.

Gautam Piplai, Indrani Chakrabarty DA, Madhumita Mukhopadhyay MS, Manas Karmakar, Sabyasachi Sarkar MS, et al. A comparative study between palonosetron and ramosetron to prevent postoperative nausea and vomiting after laparoscopic cholecystectomy. Inter Res J Pharmacy Pharmacol. 2012;2(8):193-7.

Rubenstein EB, Gralla RJ, Eisenberg P. Palonosetron (PALO) compared with ondansetron (OND) or dolasetron (DOL) for prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV): combined results of two-phase III trials. Proc Am Soc Clin Oncol. 2003;22:729.

Grote T, Hajdenberg J, Cartmell A, Ferguson S, Ginkel A, Charu V. Combination therapy for chemotherapy-induced nausea and vomiting in patients receiving moderately emetogenic chemotherapy: palonosetron, dexamethasone, and aprepitant. J Supportive Oncol. 2006;4(8):403-8.

Saito M, Aogi K, Sekine I, Yoshizawa H, Yanagita Y, Sakai H, et al. Palonosetron plus dexamethasone versus granisetron plus dexamethasone for prevention of nausea and vomiting during chemotherapy: a double-blind, double-dummy, randomised, comparative phase III trial. Lancet Oncol. 2009;10(2):115-24.




How to Cite

Ghazala, Z., Kalshetty, P., & V., A. H. (2019). Evaluation of efficacy of palonosetron versus ramosetron in patients receiving emetogenic chemotherapy. International Journal of Basic & Clinical Pharmacology, 8(4), 681–684. https://doi.org/10.18203/2319-2003.ijbcp20191099



Original Research Articles