title: Aprepitant as prophylaxis of chemotherapy-induced nausea and vomiting in anthracyclines and cyclophosphamide-based regimen for adjuvant breast cancer.
abstract: The aim of our study was to evaluate the efficacy and safety of a three-drug antiemetic prophylaxis in a single-center series treated with anthracyclines and cyclophosphamide-based regimen for BC. We collected data from 92 consecutive patients treated with routine antiemetic prophylaxis consisted of aprepitant (oral 125 mg, on day 1; oral 80 mg, on days 2 and 3), a 5-HT3 receptor antagonist (palonosetron iv 0.25 mg, on day 1), and dexamethasone (iv 12 mg, on day 1). Acute and delayed phases were defined as the first 24 h and days 2-5 after treatment, respectively. Therapy outcomes were defined as complete response (CR), in case of no vomiting, no rescue treatment; complete protection (CP), in case of no vomiting, no rescue treatment, no significant nausea; and total control (TC), in case of no vomiting, no rescue treatment, no nausea. Overall, 89.1 and 81.5% of patients showed CR in acute and delayed phase, respectively; 67.4 and 62% showed CP in acute and delayed phase, respectively; and 52.2 and 48.9% of patients showed TC in acute and delayed phase, respectively. 4.3% complained an episode of emesis during the first 24 h from treatment, while in delayed phase, only 2.2% of patients had vomiting. Our analysis confirmed that a three-drug prophylaxis is safe, effective, and consequently highly recommended in patients who undergo anthracyclines and cyclophosphamide-based regimens, though still not classified as highly emetogenic chemotherapy by all the international guidelines.
authors.affiliation: Department of Radiation Oncology, University of Florence, Largo G. A. Brambilla 3, 50134, Florence, Italy, icro.meattini@unifi.it.
authors.forename: Icro
authors.initials: I
authors.lastname: Meattini
authors.forename: Giulio
authors.initials: G
authors.lastname: Francolini
authors.forename: Vieri
authors.initials: V
authors.lastname: Scotti
authors.forename: Carla
authors.initials: C
authors.lastname: De Luca Cardillo
authors.forename: Sabrina
authors.initials: S
authors.lastname: Cappelli
authors.forename: Fiammetta
authors.initials: F
authors.lastname: Meacci
authors.forename: Ilaria Francesca
authors.initials: IF
authors.lastname: Furfaro
authors.forename: Cristina
authors.initials: C
authors.lastname: Muntoni
authors.forename: Silvia
authors.initials: S
authors.lastname: Scoccianti
authors.forename: Beatrice
authors.initials: B
authors.lastname: Detti
authors.forename: Monica
authors.initials: M
authors.lastname: Mangoni
authors.forename: Jacopo
authors.initials: J
authors.lastname: Nori
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Orzalesi
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fambrini
authors.forename: Simonetta
authors.initials: S
authors.lastname: Bianchi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livi
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage / Q000009:adverse effects; D000932:Antiemetics / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D000077608:Aprepitant; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007546:Isoquinolines / Q000627:therapeutic use; D008875:Middle Aged; D009025:Morpholines / Q000009:adverse effects / Q000627:therapeutic use*; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D000077924:Palonosetron; D011812:Quinuclidines / Q000627:therapeutic use; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D018943:Anthracyclines; D000932:Antiemetics; D007546:Isoquinolines; D009025:Morpholines; D011812:Quinuclidines; D000077608:Aprepitant; D000077924:Palonosetron; D003907:Dexamethasone; D003520:Cyclophosphamide