Fujiwara 2015.

Study characteristics
Methods	Randomised, prospective, cross‐over, comparative study with 2 arms comparison of aprepitant + palonosetron + dexamethasone vs aprepitant + granisetron + dexamethasone Enrolment period: January 2011 to January 2012 38 patients enrolled Masking: open‐label Baseline patient characteristics: reported Follow‐up: n.r.
Participants	Inclusion criteria female patients older than 20 years of age with histologically confirmed gynaecological cancer scheduled to receive a TC regimen ECOG performance status 0 to 2 meeting the following laboratory criteria: aspartate aminotransferase and alanine aminotransferase levels ≤ 2.5 × the ULN range at the facility; total bilirubin level ≤ 1.5 × the ULN range at the facility; and creatinine level ≤ 1.5 × the ULN range at the facility Exclusion criteria history of hypersensitivity to 5‐HT₃ receptor antagonists or dexamethasone risk of vomiting for other reasons (e.g. symptomatic brain metastasis, active peptic ulcer, gastrointestinal obstruction) Median age (range), years: 57.5 (36 to 76) Gender: female (38) Tumour/cancer type: gynaecological cancer (endometrial cancer, cervical cancer, ovarian or tubal cancer, double endometrial and ovarian cancer) Chemotherapy regimen: TC regimen (paclitaxel and carboplatin) Country: Japan (single centre)
Interventions	Cross‐over study Experimental: arm A: palonosetron Day 1: aprepitant 125 mg p.o. + palonosetron 0.75 mg i.v. + dexamethasone 20 mg i.v. Days 2 to 3: aprepitant 80 mg p.o. + dexamethasone 4 mg p.o. Experimental: arm B: granisetron Day 1: aprepitant 125 mg p.o. + granisetron 3 mg i.v. + dexamethasone 20 mg i.v. Days 2 to 3: aprepitant 80 mg p.o. + dexamethasone 4 mg p.o.
Outcomes	Primary endpoint complete response rate during acute (Day 1, 0 to 24 hours) and delayed periods (Days 2 to 7) Secondary endpoint(s) change in dietary intake in both acute and delayed periods
Notes	this work was supported by a JSPS KAKENHI Grant, Number 25462621 (to Y. Terai) "no potential conflict of interest relevant to this article was reported"
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "the group assignment was performed by simple randomization using a table of random numbers and patients were informed of which group (arm A or B) they were assigned"
Allocation concealment (selection bias)	Unclear risk	Comment: allocation concealment not reported
Blinding of participants and personnel (performance bias) Blinding of participants	High risk	Quote: "... non‐blinded ..."
Blinding of participants and personnel (performance bias) Blinding of personnel	High risk	Quote: "... non‐blinded ..."
Blinding of outcome assessment (detection bias) Subjective outcomes (Patient reported outcomes)	High risk	Comment: patients and personnel were not blinded towards the intervention and therefore might influence subjective outcomes analysis
Incomplete outcome data (attrition bias) Subjective outcomes (Patient reported outcomes)	Low risk	Quote: "the intent‐to‐treat population included 19 patients who received palonosetron on Day 1 (Arm A) and 19 patients who received granisetron on Day 1 (Arm B)"
Selective reporting (reporting bias)	Low risk	Comment: all outcome measures were reported in the results section
Other bias	Low risk	Comment: no information to suggest other sources of bias