Aprepitant plus palonosetron and dexamethasone for prevention of chemotherapy-induced nausea and vomiting in patients receiving multiple-day cisplatin chemotherapy

Intern Med J. 2013 Jan;43(1):73-6. doi: 10.1111/j.1445-5994.2011.02637.x.

Abstract

Background: Chemotherapy-induced nausea and vomiting remain among the most feared adverse effects for cancer patients.

Aim: The aim of this study was to evaluate the efficacy and safety of a combination of aprepitant, palonosetron and dexamethasone as antiemetic prophylaxis in patients receiving multiple-day cisplatin-based chemotherapy.

Methods: Forty-one solid cancer patients received aprepitant, palonosetron and dexamethasone during a 3-day cisplatin-based chemotherapy. Primary end-point was complete response in the overall phase (day 1 until 5 days after the end of chemotherapy).

Results: Aprepitant in combination with palonosetron and dexamethasone was safe, with hiccups (31.7%), fatigue (17.1%), headache (14.6%) and constipation (12.2%) the most common treatment-related adverse events, mostly mild. Complete response was seen in 58.5% of patients in the overall phase. In 23 patients receiving aprepitant in combination with palonosetron and dexamethasone more than one cycle (range: 2-5 cycles), the cumulative emetic protection rate after five cycles was 0.82.

Conclusion: This study shows aprepitant in combination with palonosetron and dexamethasone is safe and effectively controls chemotherapy-induced nausea and vomiting in patients undergoing 3-day cisplatin-based chemotherapy, moreover, the efficacy is maintained during multiple cycles.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Antiemetics / administration & dosage
  • Antiemetics / adverse effects
  • Antiemetics / therapeutic use*
  • Antineoplastic Agents, Alkylating / administration & dosage
  • Antineoplastic Agents, Alkylating / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Aprepitant
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects*
  • Constipation / chemically induced
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects
  • Dexamethasone / therapeutic use*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Fatigue / chemically induced
  • Female
  • Headache / chemically induced
  • Hiccup / chemically induced
  • Humans
  • Isoquinolines / administration & dosage
  • Isoquinolines / adverse effects
  • Isoquinolines / therapeutic use*
  • Male
  • Middle Aged
  • Morpholines / administration & dosage
  • Morpholines / adverse effects
  • Morpholines / therapeutic use*
  • Nausea / chemically induced
  • Nausea / prevention & control*
  • Neoplasms / drug therapy
  • Neurokinin-1 Receptor Antagonists
  • Palonosetron
  • Prospective Studies
  • Quinuclidines / administration & dosage
  • Quinuclidines / adverse effects
  • Quinuclidines / therapeutic use*
  • Serotonin 5-HT3 Receptor Antagonists / administration & dosage
  • Serotonin 5-HT3 Receptor Antagonists / adverse effects
  • Serotonin 5-HT3 Receptor Antagonists / therapeutic use
  • Vomiting / chemically induced
  • Vomiting / prevention & control*
  • Young Adult

Substances

  • Antiemetics
  • Antineoplastic Agents, Alkylating
  • Isoquinolines
  • Morpholines
  • Neurokinin-1 Receptor Antagonists
  • Quinuclidines
  • Serotonin 5-HT3 Receptor Antagonists
  • Aprepitant
  • Palonosetron
  • Dexamethasone
  • Cisplatin