SynthesisThe oncologist2019
One-Day Versus Three-Day Dexamethasone in Combination with Palonosetron for the Prevention of Chemotherapy-Induced Nausea and Vomiting: A Systematic Review and Individual Patient Data-Based Meta-Analysis.
Synthesis in The oncologist, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 9 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Efficacy and safety of dexamethasone sparing for the prevention of nausea and vomiting associated with moderately emetogenic chemotherapy: a systematic review and meta-analysis of Clinical Practice Guidelines for Antiemesis 2023 from Japan Society of Clinical Oncology.International journal of clinical oncology · 2024Pooled it
- 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting.ESMO open · 2024Guideline
- Dexamethasone-sparing strategies in anthracycline and cyclophosphamide-based chemotherapy with a focus on 5-HT3 receptor antagonists: a network meta-analysis.Frontiers in oncology · 2024Pooled it
- 2023 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following high-emetic-risk antineoplastic agents.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Pooled it
- 2023 updated MASCC/ESMO Consensus recommendations: Prevention of nausea and vomiting following moderately emetic risk antineoplastic agents.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Pooled it
- One-Day Versus Three-Day Dexamethasone with NK1RA for Patients Receiving Carboplatin and Moderate Emetogenic Chemotherapy: A Network Meta-analysis.The oncologist · 2022Pooled it
- Effectiveness of palonosetron versus granisetron in preventing chemotherapy-induced nausea and vomiting: a systematic review and meta-analysis.European journal of clinical pharmacology · 2021Pooled it
- The Balance Between the Effectiveness and Safety for Chemotherapy-Induced Nausea and Vomiting of Different Doses of Olanzapine (10 mg Versus 5 mg): A Systematic Review and Meta-Analysis.Frontiers in oncology · 2021Pooled it
- Pooled it
- Omission of dexamethasone in prophylaxis for highly emetogenic chemotherapy in patients with breast cancer.Einstein (Sao Paulo, Brazil) · 2025Trial
- A multicenter phase II trial of the triplet antiemetic therapy with palonosetron, aprepitant, and olanzapine for a cisplatin-containing regimen. - PATROL-I.Investigational new drugs · 2024Trial
- 5HTCancer science · 2021Trial
- Phase III Trial: Single Low-Dose 5 mg Dexamethasone with NEPA for Preventing 168 h Nausea and Vomiting of Diverse Highly or Moderately Emetogenic Chemotherapy (LD-NEPA).Diseases (Basel, Switzerland) · 2026Article
- Efficacy of steroid-omitting antiemetic therapy in patients with advanced pancreatic cancer receiving nano-liposomal irinotecan plus fluorouracil and leucovorin.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Article
- Validation of Steroid-Sparing Therapy in Patients Receiving Oxaliplatin-based Chemotherapy: A before-and-after Prospective Observational Study.Asian Pacific journal of cancer prevention : APJCP · 2025Observational
- Neurokinin-1 receptor antagonists in the current management of chemotherapy-induced nausea and vomiting.Frontiers of medicine · 2025Review
- Efficacy of single low-dose dexamethasone with NEPA for the 168 h prevention of highly or moderately emetogenic chemotherapy.Frontiers in pharmacology · 2025Article
- Characteristics of nausea and its impact on health-related quality of life in cisplatin-treated patients receiving dexamethasone-sparing prophylaxis: an analysis of the LUNG-NEPA study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- 2023 updated MASCC/ESMO consensus recommendations: controlling nausea and vomiting with chemotherapy of low or minimal emetic potential.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
Corrections and comments
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Authors and funding
9 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA dexamethasone-sparing regimen consisting of palonosetron plus 1-day dexamethasone for the prevention of chemotherapy-induced nausea and vomiting (CINV) has been studied previously. Here, we evaluate the noninferiority of the dexamethasone-sparing regimen in overall antiemetic control using a meta-analysis based on individual patient data (IPD). MATERIALS AND
methodsWe conducted a systematic review for randomized trials reporting CINV outcomes for the comparison of palonosetron plus 1-day dexamethasone (d1 arm) versus the same regimen followed by dexamethasone on days 2-3 after chemotherapy (d3 arm) in chemotherapy-naïve adult patients undergoing either moderately emetogenic chemotherapy (MEC) or anthracycline plus cyclophosphamide (AC)-containing chemotherapy. PubMed and MEDLINE were searched electronically. A manual search was also conducted. The primary endpoint was complete response (CR; no emesis and no rescue medication) in the overall 5-day study period. The noninferiority margin was set at -8.0% (d1 arm-d3 arm).
resultsFive studies (
conclusionThis IPD meta-analysis indicates that the dexamethasone-sparing regimen is not associated with a significant loss in overall antiemetic control in patients undergoing MEC or AC-containing chemotherapy, irrespective of known risk factors for CINV. IMPLICATIONS FOR PRACTICE: Although dexamethasone in combination with other antiemetic agents has been used to prevent chemotherapy-induced nausea and vomiting (CINV), it is of clinical importance to minimize total dose of dexamethasone in patients undergoing multiple cycles of emetogenic chemotherapy. This individual-patient-data meta-analysis from five randomized controlled trials (1,194 patients) demonstrated a noninferiority of the dexamethasone-sparing regimen for complete response and complete control of CINV. The outcomes were comparable across patients with different characteristics. These findings thus help physicians minimize use of the steroid and further reduce the burden of dexamethasone-related side effects in patients undergoing multiple consecutive courses of emetogenic chemotherapy.
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