Reducing or omitting dexamethasone with NEPA and olanzapine for prevention of chemotherapy-induced nausea and vomiting in highly emetogenic chemotherapy: a randomized non-inferiority phase III trial -
4 hours ago
- #Dexamethasone reduction
- #Chemotherapy side effects
- #CINV prevention
- A randomized non-inferiority phase III trial tested reducing or omitting dexamethasone (DEX) with NEPA and olanzapine for chemotherapy-induced nausea and vomiting (CINV) prevention in highly emetogenic chemotherapy (HEC).
- Patients received NEPA plus olanzapine and were randomized to standard DEX (12 mg day 1, 8 mg days 2-4), DEX-sparing (6 mg day 1 only), or DEX-free (no DEX).
- Primary endpoint was complete response (no emesis/no rescue) from 0-120 hours; non-inferiority margin was -12%.
- Results showed non-inferiority for both DEX-sparing (72.2% CR vs. 72.4% standard) and DEX-free (70.1% CR) regimens compared to standard DEX.
- Steroid-related toxicities were significantly lower with DEX-sparing and DEX-free regimens than with standard DEX.