Tuca, A. (2010). Use of granisetron transdermal system in the prevention of chemotherapy-induced nausea and vomiting: a review. Cancer Management and Research, 2, 1–12.

To evaluate the antiemetic efficacy of transdermal granisetron in chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately and highly emetogenic chemotherapy

• This article describes two clinical trials. The first, which was a phase II study, consisted of 210 patients with cancer. The second, which was a phase III study, consisted of 641 patients with cancer.
• Ages, gender, and key disease characteristics were not specified.

This was a multisite study conducted in the inpatient setting. The phase II trial was conducted in Germany. The phase III trial was conducted in nine countries.

All patients were in active treatment. Clinical applications of these studies are late effects and survivorship.

• The first clinical trial was a double-blind, double-dummy, randomized, multicenter study.
• The second trial was a randomized, active control, double-blind, double-dummy, parallel group, multicenter, multinational study.

In the first trial, patients used a Likert-type scale and visual analog scale (VAS) to measure CINV.

• No statistically significant differences were found in severity of nausea and vomiting, number of emetic episodes, or patient satisfaction between the two trial groups.
• Constipation was more common in patients treated with the granisetron patch compared with patients who were treated with oral granisetron.

Transdermal granisetron is effective and safe in controlling acute emesis induced by chemotherapy with moderate and high emetogenic potential; its efficacy and safety are fully comparable with those of oral granisetron.

Age, gender, cancer type, and stage were not mentioned.

The transdermal route may bring more comfort to patients. The patch is simple to apply and is maintained throughout chemotherapy without skin problems in most patients. The use of transdermal patch can avoid one of the many venous manipulations necessary in chemotherapy. Also, patches could be helpful in patients with swallowing problems.  Nurses need to consider obstacles, including cost and insurance coverage, when selecting antiemetics.