Safety and efficacy of a triple antiemetic combination with the NK-1 antagonist aprepitant in highly and moderately emetogenic multiple-day chemotherapy

Eur J Cancer. 2009 May;45(7):1184-1187. doi: 10.1016/j.ejca.2008.11.046. Epub 2009 Jan 8.

Abstract

Aim of the study: In multiple-day chemotherapy (MDC), the combination of a 5-HT(3)-antagonist plus dexamethasone is still a standard of care. The role of a NK-1-antagonist remains to be defined.

Patients and methods: Seventy eight cancer patients undergoing multiple-day chemotherapy of high (HEC) or moderate (MEC) emetic risk received granisetron, dexamethasone plus aprepitant during chemotherapy. After the end of chemotherapy, aprepitant plus dexamethasone was given for another 2 days. Primary end-point was complete response (CR) in the overall phase (day 1 until 5 days after the end of chemotherapy).

Results: Thirty eight patients underwent HEC and 40 patients underwent MEC for a median of 3.5 days. CR was seen in 57.9% and 72.5% of patients receiving HEC and MEC, respectively. The tolerability of the aprepitant regimen over 5-7 days was comparable with a 3-day aprepitant regimen.

Conclusions: This is the first report in MDC with a NK-1-antagonist containing antiemetic regimen showing a favourable safety profile with good antiemetic efficacy.

MeSH terms

  • Adult
  • Aged
  • Antiemetics / administration & dosage*
  • Antiemetics / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Aprepitant
  • Dexamethasone / administration & dosage*
  • Dexamethasone / therapeutic use
  • Drug Administration Schedule
  • Female
  • Granisetron / administration & dosage*
  • Granisetron / therapeutic use
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Morpholines / administration & dosage*
  • Morpholines / therapeutic use
  • Neoplasms / drug therapy
  • Neurokinin-1 Receptor Antagonists*
  • Safety
  • Treatment Outcome

Substances

  • Antiemetics
  • Morpholines
  • Neurokinin-1 Receptor Antagonists
  • Aprepitant
  • Dexamethasone
  • Granisetron