title: An analysis of fosaprepitant-induced venous toxicity in patients receiving highly emetogenic chemotherapy.
abstract: OBJECTIVE
  Fosaprepitant is an antiemetic used for chemotherapy-induced nausea and vomiting. We recently reported increased infusion site adverse events (ISAE) in a cohort of breast cancer patients receiving chemotherapy with doxorubicin and cyclophosphamide (AC). In this current study, we evaluated the venous toxicity of fosaprepitant use with non-anthracycline platinum-based antineoplastic regimens.
  
  
  METHODS
  A retrospective review was conducted of the first 81 patients initiated on fosaprepitant among patients receiving highly emetogenic chemotherapy, on or after January 1, 2011 at Mayo Clinic Rochester. None of these regimens included an anthracycline. Data collected included baseline demographics, chemotherapy regimen, type of intravenous access and type, and severity of ISAE. Data from these patients were compared to previously collected data from patients who had received AC. Statistical analysis using χ 2 and univariate logistic regression was used to evaluate the association between treatment regimen, fosaprepitant, and risk of ISAE.
  
  
  RESULTS
  Among these 81 patients, the incidence of ISAE was 7.4% in the non-anthracycline platinum group. The most commonly reported ISAE were swelling (3%), extravasation (3%), and phlebitis (3%). When stratified by regimen, fosaprepitant was associated with a statistically significant increased risk of ISAE in the anthracycline group (OR 8.1; 95% CI 2.0-31.9) compared to the platinum group.
  
  
  CONCLUSIONS
  Fosaprepitant antiemetic therapy causes significant ISAE that are appreciably higher than previous reports. Patients receiving platinum-based chemotherapy appear to have less significant ISAE than do patients who receive anthracycline-based regimens.
authors: Department of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA, hegerova.livia@mayo.edu.
authors: Livia T
authors: LT
authors: Hegerova
authors: Alexis D
authors: AD
authors: Leal
authors: Darryl C
authors: DC
authors: Grendahl
authors: Drew K
authors: DK
authors: Seisler
authors: Kristine M
authors: KM
authors: Sorgatz
authors: Kari J
authors: KJ
authors: Anderson
authors: Crystal R
authors: CR
authors: Hilger
authors: Charles L
authors: CL
authors: Loprinzi
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000009:adverse effects / Q000627:therapeutic use; D000932:Antiemetics / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000077608:Aprepitant; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000009:adverse effects* / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D009369:Neoplasms / Q000188:drug therapy; D010689:Phlebitis / Q000139:chemically induced*; D012189:Retrospective Studies; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D000932:Antiemetics; D000970:Antineoplastic Agents; D009025:Morpholines; D000077608:Aprepitant; C579707:fosaprepitant; D004317:Doxorubicin; D003520:Cyclophosphamide