Introduction/Background Emetogenicity of carboplatin is classified in moderate risk. Moreover, dexamethasone, 5-HT₃ receptor antagonist, and NK1 receptor antagonist are recommended to be combined. TC therapy (paclitaxel and carboplatin) is one of the major regimens in gynaecological malignant tumors. There is no definite evidence of superiority of second-generation 5-HT₃ antagonist to first-generation in triple antiemetic therapy. However, pharmaceutical prices of palonosetron, second-generation 5-HT3 antagonist are approximately 5.7 times expensive compared to granisetron, first-generation 5-HT3 antagonist. Consequently, it may result in financial stringency. Non-inferiority prospective study was planned to compare efficacy and side effects between palonosetron and granisetron.

Methodology Gynaecological malignant tumor patients over the age of 20 without history of chemotherapy and who were receiving TC therapy after June 2018 in our institution were recruited. Prior to chemotherapy, patients were intravenously administered hosaprepitant 150 mg, dexamethasone 13.2 mg, followed by palonosetron 0.75 mg or granisetron 3 mg with random allocation. This study was analyzed prospectively. Primary endpoint was delayed complete control.

Results Thirty-one patients were included in the analysis: 15 patients in palonosetron group and 16 patients in granisetron group. There were no significant differences in patient characteristics (age, PS, BMI, and type of cancer). No significant differences were seen in primary endpoint (p=0.93) and secondary endpoint; complete nausea suppression rate (p=0.59), complete vomiting suppression rate (p=0.081), administration of additional antiemetic (p=0.96), acute complete responses (p=0.56), acute complete control (p=0.096), and delayed complete responses (p=0.50).

Conclusion Possibility of non-inferiority of granisetron to palonosetron has shown in this study.