{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:55:14Z","timestamp":1785545714663,"version":"3.56.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":894,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A 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).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We 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\u20133 after chemotherapy (d3 arm) in chemotherapy-na\u00efve 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 \u22128.0% (d1 arm\u2212d3 arm).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Five studies (n = 1,194) were eligible for analysis and all IPD was collected. In the overall study period, the d1 arm showed noninferiority to the d3 arm for CR as well as complete control (pooled risk difference in CR rate \u2212 1.5%, 95% confidence interval [CI] \u22127.1 to 4.0%, I2 = 0%; in complete control rate \u2212 2.4%, 95% CI \u22127.7 to 2.9%, I2 = 0%). There was no significant interaction between dexamethasone regimen and risk factors (type of chemotherapy, sex, age, and alcohol consumption).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications for Practice<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1634\/theoncologist.2019-0133","type":"journal-article","created":{"date-parts":[[2019,6,19]],"date-time":"2019-06-19T18:49:01Z","timestamp":1560970141000},"page":"1593-1600","source":"Crossref","is-referenced-by-count":35,"title":["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"],"prefix":"10.1093","volume":"24","author":[{"given":"Yuki","family":"Okada","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan"},{"name":"Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Oba","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan"},{"name":"Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Suita Municipal Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimasa","family":"Kosaka","sequence":"additional","affiliation":[{"name":"Department of Breast and Endocrine Surgery, Kitasato University School of Medicine, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Okita","sequence":"additional","affiliation":[{"name":"Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Yuki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Department of Cancer Chemotherapy, Hokkaido University Hospital, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Celio","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Aapro","sequence":"additional","affiliation":[{"name":"Cancer Center, Clinique de Genolier, Genolier, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,6,19]]},"reference":[{"key":"2021122508132075400_onco13014-bib-0001","first-page":"1009","article-title":"Palonosetron as an anti-emetic and anti-nausea agent in oncology","volume":"3","author":"Aapro","year":"2007","journal-title":"Ther Clin Risk Manag"},{"key":"2021122508132075400_onco13014-bib-0002","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/BF00434947","article-title":"Quality of life consequences of chemotherapy-induced emesis","volume":"1","author":"Lindley","year":"1992","journal-title":"Qual Life Res"},{"key":"2021122508132075400_onco13014-bib-0003","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1093\/jjco\/hyg083","article-title":"Influence of clinical parameters on quality of life during chemotherapy in patients with advanced non-small cell lung cancer: Application of a general linear 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