Abstract
Objective: To examine the efficacy of a transdermal granisetron patch for controlling CINV in head and neck cancer patients. Significance: Head and neck cancer patients can experience mechanical obstruction or dysphagia making adherence to oral medications, including common oral antiemetics, very difficult. A granisetron transdermal system (GTS) has been shown to be as effective as oral granisetron in controlling CINV across multiple tumor types. This post-hoc analysis specifically examined the efficacy and safety of GTS in difficult to treat head and neck cancer patients. Purpose: To compare the rates of complete control (CC; no vomiting, mild nausea, no rescue medication), complete response (CR; no vomiting, no rescue medication), need for rescue medication, and patient-reported assessment in head and neck cancer patients using either GTS or oral granisetron. Methods: A randomized, phase 3 study has been published comparing GTS (7 day application) to oral granisetron (2 mg/day) in patients receiving either moderately or highly emetogenic chemotherapy for 3-5 days. Data for this analysis were limited to patients with head and neck primary tumors. Results: 71 patients (38 GTS, 33 oral granisetron) were included. The CC rate of 66% and CR rate of 68% in the GTS group were similar to rates in the overall population. There was no difference in CC, CR, and use of rescue medication between GTS and oral granisetron (p = .94, .91, and .57, respectively). Patient assessment of overall response to therapy was not different between arms (p = .26). GTS was well tolerated, and treatment-related adverse events were mild. Discussion: This retrospective analysis suggests GTS may be an appropriate option for prevention of CINV in head and neck cancer patients at high risk of dysphagia treated with chemotherapy. Most curriculums do not include integrative modalities.
