The neurokinin1 receptor antagonist aprepitant as an antiemetic for moderately emetogenic chemotherapy.
The neurokinin-1 (NK1) receptor antagonist aprepitant has become part of standard antiemetic therapy for high-dose cisplatin. Recent results indicate that chemotherapy for breast cancer that contains an anthracycline plus cyclophosphamide is more emetogenic than has been previously realised. One large randomised trial demonstrated that aprepitant substantially reduces the risk of vomiting or retching when added to a corticosteroid and a 5-hydroxytryptamine 3 (HT3) receptor antagonist. The adverse effects of standard antiemetics and chemotherapy do not appear to be increased by the addition of this novel antiemetic agent. Aprepitant should now also be considered to be part of prophylactic antiemetic therapy for women who receive chemotherapy that contains an anthracycline and cyclophosphamide. The role of NK1 receptor antagonists in preventing emesis due to other cytotoxic agents that are deemed to be moderately emetogenic is still unclear.
Warr
David
D
Princess Margaret Hospital, Department of Medical Oncology and Hematology, 610 University Avenue, Toronto, Ontario, M5G 2M9, Canada. david.warr@uhn.on.ca
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D018943:Anthracyclines / Q000008:administration & dosage; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000932:Antiemetics / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D000077608:Aprepitant; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D002945:Cisplatin / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage; D018492:Dopamine Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D009025:Morpholines / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D064729:Neurokinin-1 Receptor Antagonists; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D018040:Receptors, Neurokinin-1 / Q000378:metabolism; D044406:Receptors, Serotonin, 5-HT3 / Q000378:metabolism; D058831:Serotonin 5-HT3 Receptor Antagonists; D014839:Vomiting / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*
D000305:Adrenal Cortex Hormones; D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D000932:Antiemetics; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D018492:Dopamine Antagonists; D009025:Morpholines; D064729:Neurokinin-1 Receptor Antagonists; D018040:Receptors, Neurokinin-1; D044406:Receptors, Serotonin, 5-HT3; D058831:Serotonin 5-HT3 Receptor Antagonists; D000077608:Aprepitant; D003520:Cyclophosphamide; D002945:Cisplatin