title: Efficacy of triple antiemetic therapy (palonosetron, dexamethasone, aprepitant) for chemotherapy-induced nausea and vomiting in patients receiving carboplatin-based, moderately emetogenic chemotherapy.
abstract: BACKGROUND
  Chemotherapy-induced nausea and vomiting (CINV) is a major adverse toxicity of cancer chemotherapy. Recommended treatments for prevention of CINV vary among published guidelines, and optimal care for CINV caused by moderately emetogenic chemotherapy has not been established. This study assessed the efficacy and safety of triple antiemetic therapy comprising palonosetron, dexamethasone and aprepitant for carboplatin-based chemotherapy. Chemotherapy-naïve patients with lung cancer scheduled for a first course of a carboplatin-containing regimen formed the study cohort. Patients were pretreated with antiemetic therapy comprising palonosetron (0.75 mg, i.v.) and dexamethasone (9.9 mg, i.v.) on day 1, and aprepitant (125 mg, p.o.) on day 1 followed by 80 mg on days 2 and 3. Primary endpoint was the proportion of patients who did not experience vomiting and did not require rescue medication [complete response (CR)] in the acute phase (0-24 h), late phase (24-168 h) and overall. Secondary endpoint was the proportion of patients who experienced no vomiting episodes and no more than mild nausea without the need for rescue medication [complete control (CC)].
  
  
  RESULTS
  Prevalence of a CR during the acute phase, delayed phase, and overall was 100, 91.9 and 91.9%, whereas that of CC was 100, 84.4 and 84.4%, respectively. The most common adverse event was mild constipation; severe adverse events related to antiemetic treatment were not observed.
  
  
  CONCLUSIONS
  Triple antiemetic therapy comprising palonosetron, dexamethasone and aprepitant shows excellent effects in the prevention of CINV in patients receiving a carboplatin-containing regimen.
authors.affiliation: Department of Pulmonary Medicine/Medical Oncology, Nippon Medical School, Tamanagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512 Japan.
authors.forename: Toshimichi
authors.identifier: 0000-0001-7384-9513
authors.initials: T
authors.lastname: Miya
authors.affiliation: Department of Pulmonary Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Pulmonary Medicine, Nippon Medical School, Chiba Hokusoh Hospital, Inzai, Chiba Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Hino
authors.affiliation: Department of Pulmonary Medicine, Jizankai Medical Foundation Tsuboi Cancer Center Hospital, Kohriyama, Fukushima Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ando
authors.affiliation: Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Takeuchi
authors.affiliation: Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Seike
authors.affiliation: Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kubota
authors.affiliation: Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Gemma
keywords: Aprepitant; Dexamethasone; Moderately emetogenic chemotherapy; Palonosetron; Triple antiemetic therapy