GRANISETRON TRANSDERMAL DELIVERY SYSTEM USE IN LYMPHOPROLIFERATIVE DISEASE: A SINGLE CENTER EXPERIENCE

Background: Chemotherapy induced nausea and vomiting (CINV) represents a major impairment of quality of life in patients who undergo to a single-day and multi-day chemotherapy leading to a lower adherence to further chemotherapies. The prevention of acute (0-24 h) and delayed (25-120 h) CINV associated with moderately emetogenic chemotherapy (MEC-AC based) and highly emetogenic chemotherapy (HEC) recommented by international guidelines (MASCC, NCCN, ASCO) consists in a combination of corticosteroids (i.e. dexametasone), type 3 serotonine receptor antagonist (5HT3Ra) and neurokinin-1 receptor antagonist (NK1Ra). Granisetron Transdermal Delivery System (GTDS) was developed as 5HT3Ra for CINV prophylaxis over 7 days. Methods: In this retrospective non comparative single center experience a total 19 outpatients were observed from Nov 2016 to March 2019: 13 pt were female and 6 were male, median age of pts in treatment was 52 yrs (range: 26-69). 5 Pts with cHodgkin Lymphoma, 2 pts Marginal Zone Lymphoma, 3 Mantle Cell Lymphoma, 2 Primary Mediastinal Large Cell Lymphoma, 2 pts Follicolar Lymphoma, 4 pts with Diffuse Large B Cell Lymphoma. GTDS was used as second line therapy after Ondansetron iv in MEC (Bendamustine, CHOP) and in HEC (Cisplatin-based CHT) instead was used as third line after palonosetron i.v. and Netupitant-Palonosetron p.o. in Dacarbazine based CHT. A multi-day CHT (range: 2-4 days) was administered in 6/19 pts. A single dose patch granisetron was administered a day before CHT for 7 days continuously. The complete remission consists in complete control (CC) of acute and delayed CINV (no vomiting/retching, no nausea, no other rescue medication).The tolerability was evaluated true reported adverse events and laboratory data as AST, ALT, creatinine and potassium. Results: GTDS was safe and no dizziness, headache or severe constipation were observed. CC was observed in 83% (5/6) of symptomatic pts during acute CINV and 81% (13/16) of pts with delayed CINV. DTDS failed in 19% (3/16) of pts with delayed CINV and other medications such as metoclopramide, promazine and aprepitant were administered. A good control of delayed CINV was evidenced in multi-day CHT's pts. No significant increase of AST and ALT were observed and mild hyperkaliemia was reported only 2/19 pts. Conclusion: The GTDS provides effective, well tolerated control of CINV associated with MEC or HEC in one or multi day chemotherapy. Keywords: ABVD; classical Hodgkin lymphoma (cHL); diffuse large B-cell lymphoma (DLBCL).