Which combination is commonly used for moderately emetogenic regimens?

• A. Dexamethasone alone
• B. Dexamethasone plus Palonosetron
• C. Ondansetron alone
• D. Prokinetic agent only

Answer: (B)

For moderately emetogenic chemotherapy, effective prevention needs to cover both the immediate (acute) and later (delayed) phases of nausea and vomiting. Dexamethasone provides antiemetic effects and helps boost other drugs, while palonosetron blocks serotonin receptors and, with its long half-life, offers sustained protection into the delayed phase. This combination delivers reliable control across both phases, which is why it’s commonly used for moderate emetogenic regimens. Using a single agent lacks either receptor blockade or durable activity, making it less effective for moderate risk. Prokinetic agents alone don’t provide adequate coverage for this level of emetogenicity.