Ramosetron, Aprepitant, and Dexamethasone Versus Palonosetron, Aprepitant, and Dexamethasone

Inclusion Criteria:

* The patient's age is ≥ 19 years old
* Histologically or cytologically confirmed solid tumor
* Patients diagnosed as malignancy who will be treated with highly emetogenic chemotherapeutic agents (NCCN guideline v2.0, 2014 anti-emesis). (Cisplatin dosage is over 50mg/m2, combination therapy is available with other chemotherapeutic agents and including lymphoma)
* Eastern Cooperative Oncology Group (ECOG) performance status 0-2
* Available oral administration of study drugs
* Adequate organ functions as follows: 1) Hematologic - white blood cell count (WBC) ≥ 3000 microliter (microL) or Neutrophil≥ 1500 micro/L, Platelet ≥ 100,000/microL; 2) Serum Creatinine ≤ 1.5 times upper limit of normal; 3) Hepatic function - Total bilirubin, AST, ALT ≤2.5 times upper limit of normal, ALP ≤ 2 times upper limit of normal( except ALP increasing due to bone metastasis
* Patients with normal range of serum K, Mg and hold serum Ca over lower limit of normal range
* Patients must sign an informed consent indicating that they are aware of the investigational nature of the study in keeping with the policy of the hospital

Exclusion Criteria:

* Patients with severe Hypertension, severe Heart disease, congenital long QT syndrome, bradyarrhythmia severe kidney disease(serum creatinine≥3㎎/㎗), liver disease (AST, ALT ≥ 2.5 times of upper normal range, ALP ≥ 2 times of upper normal range)
* Patients with GI obstruction, active gastric ulcer or other diseases that could provoke nausea and vomiting
* Patients who have nausea and vomiting within 1 week before chemotherapy
* Patients who should take steroid, antiemetics, antipsychotic agent including benzodiazepine, pimozide, terfenadine, astemizole, cisapride, rifampin, carbamazepine, phenytoin, ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir or nelfinavir, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors for the treatment of other diseases
* Patients with brain tumor, brain metastasis or seizure
* Patients receiving chemotherapy within 6 months before enrollment
* Patients who need radiation therapy during study period or receiving radiation therapy within 2 weeks before chemotherapy
* Patients who have known allergy or severe side effect on study drugs(5-HT3 antagonist and aprepitant)
* Pregnant or lactating women, or women who wish to become pregnant
* Patients with drug abuse, a mental disease and difficult to communicate with investigators
* Others whom the investigator judges inappropriate as subjects for this study