The NK-1 receptor-antagonist aprepitant in high-dose chemotherapy (high-dose melphalan and high-dose T-ICE: paclitaxel, ifosfamide, carboplatin, etoposide): efficacy and safety of a triple antiemetic combination.
Complete protection from nausea/vomiting is currently achieved in a minority of patients receiving high-dose chemotherapy (HDC). Currently the use of 5-HT3-antagonists and dexamethasone (DEX) represents the standard of care. The role of the NK-1-antagonist aprepitant in HDC remains to be better defined. A total of 64 patients undergoing multiple days of HDC received granisetron, DEX plus aprepitant during chemotherapy. After the end of chemotherapy aprepitant plus DEX was given for a further 2 days. Primary end point was CR defined as no vomiting and no use of rescue medication in the overall phase (day 1 until 5 days after end of chemotherapy). Acute/delayed and overall CR were achieved in 83%/70% and 63%, respectively. Acute and delayed nausea were observed in 20 and 38% of the patients. The tolerability of the aprepitant regimen over 4-5 days was comparable with the 3-day antiemetic regimen. In our study, aprepitant demonstrated good tolerability. Taking into account the methodological constraints of comparing our results with those from the available literature, the addition of aprepitant to the antiemetic treatment regimen may provide improved prevention of chemotherapy-induced nausea and vomiting during HDC.
Jordan
K
K
Department of Internal Medicine IV Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany. Karin.jordan@medizin.uni-halle.de
Jahn
F
F
Jahn
P
P
Behlendorf
T
T
Stein
A
A
Ruessel
J
J
Kegel
T
T
Schmoll
H-J
HJ
D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000077608:Aprepitant; D016190:Carboplatin; D004338:Drug Combinations; D064420:Drug-Related Side Effects and Adverse Reactions; D005047:Etoposide; D005260:Female; D017829:Granisetron / Q000627:therapeutic use; D006801:Humans; D007069:Ifosfamide; D008297:Male; D008558:Melphalan / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage* / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control; D064729:Neurokinin-1 Receptor Antagonists; D017239:Paclitaxel; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control; D055815:Young Adult
D000932:Antiemetics; D000077608:Aprepitant; D016190:Carboplatin; D004338:Drug Combinations; D005047:Etoposide; D017829:Granisetron; D007069:Ifosfamide; D008558:Melphalan; D009025:Morpholines; D064729:Neurokinin-1 Receptor Antagonists; D017239:Paclitaxel