Antiemetic Efficacy of Metoclopramide

To the Editor: The study of Gralla et al. (October 15 issue*) is of great interest and is scientific. However, one can no longer consider it ethical to use placebos in research on antiemetics; withholding an antiemetic agent in such circumstances must make a difference in overall mortality, since there will be a loss of compliance with the chemotherapeutic regimen. The increase in morbidity cannot be measured directly, but it must be considerable. Future studies should be directed at comparing antiemetic agents only.