title: Aprepitant plus granisetron and dexamethasone for prevention of chemotherapy-induced nausea and vomiting in patients with gastric cancer treated with S-1 plus cisplatin.
abstract: BACKGROUND
  We aimed to evaluate the efficacy of a new combination antiemetic therapy comprising aprepitant, granisetron, and dexamethasone in gastric cancer patients undergoing chemotherapy with cisplatin and S-1.
  
  
  METHODS
  Gastric cancer patients scheduled to receive their first course of chemotherapy with cisplatin (60 mg/m(2)) and S-1 (80 mg/m(2)) were treated with a new combination antiemetic therapy aprepitant, granisetron, and dexamethasone on day 1; aprepitant and dexamethasone on days 2 and 3; and dexamethasone on day 4. The patients reported vomiting, nausea, use of rescue therapy, and change in the amount of diet intake, and completed the Functional Living Index-Emesis (FLIE) questionnaire. The primary endpoint was complete response (CR; no emesis and use of no rescue antiemetics) during the overall study phase (0-120 h after cisplatin administration). The secondary endpoints included complete protection (CP; CR plus no significant nausea); change in the amount of diet intake; and the impact of chemotherapy-induced nausea and vomiting (CINV) on daily life during the overall, acute (0-24 h), and delayed (24-120 h) phases.
  
  
  RESULTS
  Fifty-three patients were included. CR was achieved in 88.7, 98.1, and 88.7% of patients in the overall, acute, and delayed phases, respectively. The corresponding rates of CP were 67.9, 96.2, and 67.9%. Approximately half of the patients had some degree of anorexia. FLIE results indicated that 79.5% of patients reported "minimal or no impact of CINV on daily life".
  
  
  CONCLUSIONS
  Addition of aprepitant to standard antiemetic therapy was effective in gastric cancer patients undergoing treatment with cisplatin and S-1.
authors: Department of Gastroenterological Surgery, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan, oya-ma@staff.kanazawa-u.ac.jp.
authors: Katsunobu
authors: K
authors: Oyama
authors: Sachio
authors: S
authors: Fushida
authors: Masahide
authors: M
authors: Kaji
authors: Toshiya
authors: T
authors: Takeda
authors: Shinichi
authors: S
authors: Kinami
authors: Yasuo
authors: Y
authors: Hirono
authors: Katsuhiro
authors: K
authors: Yoshimoto
authors: Kazuhisa
authors: K
authors: Yabushita
authors: Hisashi
authors: H
authors: Hirosawa
authors: Yuki
authors: Y
authors: Takai
authors: Tatsuo
authors: T
authors: Nakano
authors: Hironobu
authors: H
authors: Kimura
authors: Toshiaki
authors: T
authors: Yasui
authors: Atsushi
authors: A
authors: Tsuneda
authors: Tomoya
authors: T
authors: Tsukada
authors: Jun
authors: J
authors: Kinoshita
authors: Takashi
authors: T
authors: Fujimura
authors: Tetsuo
authors: T
authors: Ohta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D000077608:Aprepitant; D002945:Cisplatin / Q000008:administration & dosage; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D017829:Granisetron / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000009:adverse effects / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000008:administration & dosage; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D000077608:Aprepitant; D002945:Cisplatin; D003907:Dexamethasone; D004338:Drug Combinations; D017829:Granisetron; D009025:Morpholines; D010094:Oxonic Acid; D005641:Tegafur; C079198:S 1 (combination)