Keyhanian, S., Taziki, O., Saravi, M.M., & Fotokian, Z. (2009). A randomized comparison of granisetron plus dexamethasone with granisetron alone for the control of acute chemotherapy-induced emesis and nausea. International Journal of Hematology-Oncology and Stem Cell Research, 3, 27–30.

To compare granisetron plus dexamethasone to granisetron alone in the prevention of acute emesis

Patients were randomly assigned to receive either granisetron alone or in combination with dexamethasone. One group received a single IV dose of 3 mg granisetron and the other group received 3 mg IV granisetron and 8 mg IV dexamethasone 30 minutes prior to chemotherapy. Patients were evaluated for 24 hours. Efficacy was determined according to a scale established by investigators.

• The study consisted of 125 participants, 63 in the granisetron only group (group 1) and 62 in the granisetron plus dexamethasone group (group 2).
• Median age was 64 years old in group 1, with a range of 40–72 years, and 63 years old in group 2, with a range of 20–70 years.
• The granisetron group was 33% female and the granisetron plus dexamethasone group was 40% female.
• Cancer diagnoses were GI, breast, and hematologic.
• The majority of patients (79% in group 1 and 77% in group 2) were receiving more than 60 mg/m² of cisplatin.

The study was conducted at a single setting in Iran.

All patients were in active treatment.

This was a randomized, single-blind, prospective study.

The number of emetic episodes was recorded. Complete response was defined as no emetic episodes.

The investigators developed a scale to record efficacy of the intervention with \"moderately effective\" defined as \"did not interfere with daily life,\" \"slightly effective\" as \"interfered with normal daily life,\" and \"not effective\" as \"bedridden due to nausea.\"

A higher percentage of patients (66.7%) in the group receiving both granisetron and dexamethasone had 0 emesis episodes, compared to fewer than half (42.8%) of patients who received granisetron alone (p < 0.0001).

The combination of granisetron plus dexamethasone was superior to granisetron alone for prevention of acute emesis.

• Minimal information was provided on the chemotherapeutic regimens used.
• The authors did not indicate if patients were chemotherapy naïve.
• Some data, such as age ranges and average reported, were different in the abstract than the body of the article, leading to questionable overall report.
• No valid, common measure of nausea and vomiting was used, and how this was recorded was not clear.

Findings indicate that dexamethasone should be included in antiemetic regimens, which is consistent with current care standards.