While the use of 5-HT3 receptor antagonists is clearly justified in patients 
receiving cisplatin, their role with less emetic drugs is still not defined. The 
aim of our randomized study was to verify the efficacy of the single standard 
dose of three 5-HT3-receptor-antagonists in moderately emetic chemotherapies. 
Sixty chemotherapy-naive breast cancer patients of 30 to 71 years in age, P.S. = 
0-1, receiving 5-fluorouracil-epirubicin-cyclophosphamide (FEC 75) q 21 days or 
cyclophosphamide-methotrexate-5-fluorouracil (CMF) or 120 mg/m2 epirubicin or 
high dose mitomycin-methotrexate-mitoxantrone (MMM) q 14 days (+ G-CSF) or 100 
mg/m2 epirubicin (+ G-CSF) were randomized to receive, 15 min before 
chemotherapy, 8 mg i.v. bolus of ondansetron or 3 mg i.v. granisetron or 5 mg 
i.v. tropisetron and no further antiemetic therapy in the following days. 180 
cycles were evaluable. Complete protection, (the absence of vomiting episodes,) 
was respectively 75%, 70% and 70% in the acute and 70%, 82%, 72% in the delayed 
phases, and an absence of nausea was 56%, 37% and 20% in the acute phase and 
50%, 35% and 27% in the delayed, respectively. Complete response, (absence of 
vomiting and absence or mild nausea,) was 74%, 58.6% and 50.8% in the acute and 
64%, 63.7%, 47.3% in the delayed phases, respectively. At the statistical 
analysis no significant differences between the three drugs were found regarding 
acute vomiting while ondansetron was superior to granisetron and tropisetron in 
acute (p = 0.018; p < 0.05) and delayed nausea (P = 0.104; p < 0.01). This 
activity is practically the same as that we reported (Ann Oncol 1994; 6, suppl 
8: 204) with a loading dose on day 1 and maintenance for the following 2-5 days, 
but with a significantly favorable cost-benefit ratio.