***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE Aprepitant , a 5-HT3 receptor antagonist ( 5HT3-RA ) , and dexamethasone are st and ard antiemetic therapy for prevention of single-day , cisplatin-induced nausea and vomiting . We conducted a double-blind , placebo-controlled phase III cross-over study that compared aprepitant to placebo combined with st and ard antiemetic prophylaxis ( a 5HT3-RA and dexamethasone ) in patients receiving 5 days of cisplatin combination chemotherapy for testicular cancer . PATIENTS AND METHODS Patients receiving two consecutive identical courses of a 5-day cisplatin-based chemotherapy  were r and omly assigned to aprepitant 125 mg on day 3 and 80 mg per day on days 4 through 7 or to placebo with the initial course and crossover to the opposite treatment with the second course . The primary objective was complete response ( CR ) . Secondary end points were emetic episodes ( acute and delayed ) , nausea measurement based on a visual analog scale ( VAS ) , and patient-stated preference after the second study cycle . RESULTS In all , 71 patients were screened for the study and 69 were evaluable . Thirty-five patients were r and omly assigned to receive aprepitant and 34 to receive placebo for the first course . Forty-two percent achieved CR with aprepitant compared with 13 % with placebo ( P < .001 ) . Eleven patients ( 16.2 % ) had at least one emetic episode during the aprepitant cycle versus 32 patients ( 47.1 % ) with placebo . Thirty-eight patients preferred the aprepitant cycle whereas 11 preferred placebo ( P < .001 ) . There was no statistical difference in VAS for nausea , but it was numerically superior with aprepitant . There was no toxicity with aprepitant compared with placebo . CONCLUSION There was a significant improvement in CR rate with aprepitant combined with a 5HT3-RA and dexamethasone . Patient preference strongly favored the aprepitant cycle BACKGROUND This pivotal phase III trial evaluated the efficacy and safety of palonosetron in preventing acute and delayed chemotherapy-induced nausea and vomiting ( CINV ) following highly emetogenic chemotherapy ( HEC ) . PATIENTS AND METHODS Patients were r and omized to a single intravenous dose of palonosetron 0.25 mg or 0.75 mg , or ondansetron 32 mg prior to HEC . Dexamethasone pre-treatment ( with stratification ) was used at investigator discretion . The primary efficacy endpoint was the proportion of patients with  complete response ( CR ) during the first 24 h post-chemotherapy ( acute phase ) . RESULTS In the intent-to-treat analysis ( n = 667 ) , palonosetron 0.25 mg and 0.75 mg were at least as effective as ondansetron in preventing acute CINV ( 59.2 % , 65.5 % , and 57.0 % CR rates , respectively ) ; CR rates were slightly higher with palonosetron than ondansetron during the delayed ( 24 - 120 h ) and overall ( 0 - 120 h ) phases . Two thirds of patients ( n = 447 ) received concomitant dexamethasone . Patients pre-treated with palonosetron 0.25 mg plus dexamethasone had significantly higher CR rates than those receiving ondansetron plus dexamethasone during the delayed ( 42.0 % versus 28.6 % ) and overall ( 40.7 % versus 25.2 % ) phases . Palonosetron and ondansetron were well tolerated . CONCLUSIONS Single-dose palonosetron was as effective as ondansetron in preventing acute CINV following HEC , and with dexamethasone pre-treatment , its effectiveness was significantly increased over ondansetron throughout the 5-day post-chemotherapy period BACKGROUND Explore safety and efficacy of three palonosetron-containing regimens for emesis prevention over 7 days in multiple myeloma ( MM ) patients receiving melphalan ( 100 mg/m(2 ) ) and hematopoietic stem cell transplantation ( HSCT ) . PATIENTS AND METHODS R and omized , double-blind pilot study in MM patients ( n=73 ) receiving 1 , 2 , or 3 days of 0.25 mg palonosetron  ( 30-s i.v . bolus ) 30 min before melphalan ( days -2 and -1 ) and HSCT ( day 0 ) . Patients received dexamethasone ( 20 mg i.v . , days -2 and -1 ) immediately before or after study drug/placebo . Daily diaries recorded emesis , rescue medication , nausea duration , and adverse events ( AEs ) . RESULTS Seven-day complete protection ( no emesis ) occurred in 41.7 % [ 95 % confidence interval ( CI ) 22.1 % to 63.4 % ] , 41.7 % ( 95 % CI 22.1 % to 63.4 % ) , and 44.0 % ( 95 % CI 24.2 % to 65.1 % ) of patients receiving 1 , 2 , or 3 days of palonosetron , respectively ( P=0.43 ) . Complete response ( emesis free without rescue medication ) occurred in 8.3 % , 20.8 % , and 20.0 % ( P=0.14 ) . Common AEs ( ≥10 % ) were mild-to-moderate diarrhea , constipation , headache , insomnia , and flatulence . No serious AEs occurred . CONCLUSIONS Palonosetron with dexamethasone was safe and effective in preventing emesis in MM patients receiving melphalan and HSCT . This pilot study with a limited number of patients suggests that multiple doses of palonosetron could be more effective than a single dose in making patients emesis free without need for rescue medication . However , even multiple doses of palonosetron result ed in only 20 % of patients being emesis free without rescue medication , suggesting that further improvement will require development of more effective combination antiemetic therapy BACKGROUND The localization of substance P in brain-stem regions associated with vomiting , and the results of studies in ferrets , led us to postulate that a neurokinin-1-receptor antagonist would be an antiemetic in patients receiving anticancer chemotherapy . METHODS In a multicenter , double-blind , placebo-controlled trial involving 159 patients who had not previously received cisplatin  , we evaluated the prevention of acute emesis ( occurring within 24 hours ) and delayed emesis ( on days 2 to 5 ) after a single dose of cisplatin therapy ( 70 mg or more per square meter of body-surface area ) . Before receiving cisplatin , all the patients received granisetron ( 10 microg per kilogram of body weight intravenously ) and dexamethasone ( 20 mg orally ) . The patients were r and omly assigned to one of three treatments in addition to granisetron and dexamethasone : 400 mg of an oral trisubstituted morpholine acetal ( also known as L-754,030 ) before cisplatin and 300 mg on days 2 to 5 ( group 1 ) , 400 mg of L-754,030 before cisplatin and placebo on days 2 to 5 ( group 2 ) , or placebo before cisplatin and placebo on days 2 to 5 ( group 3 ) . Additional medication was available at any time to treat occurrences of vomiting or nausea . RESULTS In the acute-emesis phase , 93 percent of the patients in groups 1 and 2 combined and 67 percent of those in group 3 had no vomiting ( P<0.001 ) . In the delayed-emesis phase , 82 percent of the patients in group 1 , 78 percent of those in group 2 , and 33 percent of those in group 3 had no vomiting ( P<0.001 for the comparison between group 1 or 2 and group 3 ) . The median nausea score in the delayed-emesis phase was significantly lower in group 1 than in group 3 ( P=0.003 ) . No serious adverse events were attributed to L-754,030 . CONCLUSIONS The neurokinin-1-receptor antagonist L-754,030 prevents delayed emesis after treatment with cisplatin . Moreover , combining L-754,030 with granisetron plus dexamethasone improves the prevention of acute emesis OBJECTIVES To evaluate the antiemetic effect of a single dose of ondansetron and dexamethasone as a prophylaxis for chemotherapy induced acute nausea and emesis and factors associated with the control of acute nausea and emesis . MATERIAL AND METHOD Patients who received single dose of 8 mg ondansetron and 20 mg dexamethasone as a prophylaxis for chemotherapy induced nausea and emesis at Department of Obstetrics and Gynecology , Bangkok Metropolitan Administration Medical College and Vajira Hospital , between October 2004 and April 2006 were identified . The assessment record of the drug efficacy had been evaluated in the first 24 hours after the start of chemotherapy in terms of control of vomiting , and nausea . Age of the patients , history of alcohol intake , type of cancer , regimen of chemotherapy and course of chemotherapy were analysed as possible factors associated with the control of nausea and emesis . RESULTS Seventy-eight gynecologic-cancer patients receiving 353 cycles of chemotherapy were evaluated in this study . Completed control of acute vomiting and nausea were 68 % and 57.2 % respectively . Complete control of acute vomiting and nausea were 56.9 % and 45.4 % in patients of < or = 45 years compared to 78.8 % and 68.7 % in those with > 45 years . Complete control of acute vomiting and nausea were 59.2 % and 48.7 % in those receiving cisplatin-containing regimens compared to 86.7 % and 75.2 % in non-cisplatin containing regimens . Univariable and multivariable analysis showed that younger patients and those who received cisplatin-containing regimens had significant lower rates of complete control of both nausea and emesis . Patients receiving the first three courses of chemotherapy had significantly higher rate of complete control of nausea but not emesis as compared to those receiving chemotherapy after the third course . CONCLUSION A single intravenous dose of 8 mg of ondansetron and 20 mg of dexamethasone had good control of acute nausea and vomiting only in those who received non-cisplatin containing regimens and those older than 45 years Palonosetron , a highly selective and potent 5‐HT3 receptor antagonist with a strong binding affinity and a long plasma elimination half‐life ( approximately 40 hours ) , has shown efficacy in Phase II trials in preventing  chemotherapy‐induced nausea and vomiting ( CINV )  result ing from highly emetogenic chemotherapy . The current Phase III trial evaluated the efficacy and safety of palonosetron in preventing acute and delayed CINV after moderately emetogenic chemotherapy BACKGROUND To reduce side-effects of corticosteroid-containing antiemetic regimens , tailoring antiemetic schedules to specific requirements of different patients could be of benefit . We evaluated the possibility to reduce the total dose of corticosteroids when palonosetron , a long-acting second-generation 5-hydroxytryptamine-3 ( 5-HT(3 ) ) receptor antagonist , is used . MATERIAL S AND METHODS Double-blind , multicentre , noninferiority study of chemotherapy-naive breast cancer patients receiving 0.25 mg palonosetron and 8 mg dexamethasone on day 1 , r and omly assigned to receive placebo ( n = 151 ) or 4 mg b.i.d . dexamethasone ( n = 149 ) on days 2 and 3 . Primary end point was complete response ( CR ) rate ( no emesis , no rescue medication ) in the overall ( days 1 - 5 ) period . Secondary end points were CR rates in the acute ( day 1 ) and delayed ( days 2 - 5 ) periods , rates of no emesis and no nausea and impact on daily functioning ( Functional Living Index-Emesis ) . RESULTS Noninferiority between the two treatments was demonstrated by similar CR rates ( P = 0.487 ) in the overall period . Most parameters showed that palonosetron and dexamethasone on day 1 only offer chemotherapy-induced nausea and vomiting protection similar to multiple-day dexamethasone administration . CONCLUSION In patients treated with a single injection of palonosetron on day 1 , reducing dexamethasone is an option that is not associated with significant reduction in antiemetic control during the 5-day period or an impact on patient functioning BACKGROUND Although currently available 5-hydroxytryptamine type 3 receptor ( 5-HT3 ) antagonists are effective , not all patients receiving these agents achieve adequate control of chemotherapy-induced nausea and vomiting ( CINV ) . Palonosetron , a potent and highly 
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EXPERT OPINION Palonosetron was the only serotonin receptor antagonist approved for prevention of delayed CINV caused by MEC and its use was incorporated in guideline recommendations .