Aprepitant in patients with advanced non-small-cell lung cancer receiving carboplatin-based chemotherapy

Ito, Yasuhiro; Karayama, Masato; Inui, Naoki; Kuroishi, Shigeki; Nakano, Hideki; Nakamura, Yutaro; Yokomura, Koshi; Toyoshima, Mikio; Shirai, Toshihiro; Masuda, Masafumi; Yamada, Takashi; Yasuda, Kazumasa; Hayakawa, Hiroshi; Suda, Takafumi; Chida, Kingo

doi:10.1016/j.lungcan.2014.03.017

Cited by 62 publications

(79 citation statements)

References 26 publications

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“…The addition of aprepitant to standard antiemetic regimens yielded absolute benefits of 14% for the measure of no emesis in the overall phase16, 19 and for the CR rate in the overall phase20 in carboplatin‐treated patients. Smaller studies have produced inconsistent results for the benefit of aprepitant in patients administered carboplatin therapy 21, 22, 23. Data on netupitant also suggest a similar benefit based on measures of no emesis and CR in the overall phase with historical controls used for comparison 17, 24.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the neurokinin‐1 receptor antagonist rolapitant in preventing nausea and vomiting in patients receiving carboplatin‐based chemotherapy

Hesketh

Schnadig

Schwartzberg

et al. 2016

Cancer

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BACKGROUNDRolapitant, a novel neurokinin‐1 receptor antagonist, provided effective protection against chemotherapy‐induced nausea and vomiting (CINV) in a randomized, double‐blind phase 3 trial of patients receiving moderately emetogenic chemotherapy or an anthracycline and cyclophosphamide regimen. The current analysis explored the efficacy and safety of rolapitant in preventing CINV in a subgroup of patients receiving carboplatin.METHODSPatients were randomized 1:1 to receive oral rolapitant (180 mg) or a placebo 1 to 2 hours before chemotherapy administration; all patients received oral granisetron (2 mg) on days 1 to 3 and oral dexamethasone (20 mg) on day 1. A post hoc analysis examined the subgroup of patients receiving carboplatin in cycle 1. The efficacy endpoints were as follows: complete response (CR), no emesis, no nausea, no significant nausea, complete protection, time to first emesis or use of rescue medication, and no impact on daily life.RESULTSIn the subgroup administered carboplatin‐based chemotherapy (n = 401), a significantly higher proportion of patients in the rolapitant group versus the control group achieved a CR in the overall phase (0‐120 hours; 80.2% vs 64.6%; P < .001) and in the delayed phase (>24‐120 hours; 82.3% vs 65.6%; P < .001) after chemotherapy administration. Superior responses were also observed by the measures of no emesis, no nausea, and complete protection in the overall and delayed phases and by the time to first emesis or use of rescue medication. The incidence of treatment‐emergent adverse events was similar for the rolapitant and control groups.CONCLUSIONSRolapitant provided superior CINV protection to patients receiving carboplatin‐based chemotherapy in comparison with the control. These results support rolapitant use as part of the antiemetic regimen in carboplatin‐treated patients. Cancer 2016;122:2418–2425. © 2016 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Efficacy of the neurokinin‐1 receptor antagonist rolapitant in preventing nausea and vomiting in patients receiving carboplatin‐based chemotherapy

Hesketh

Schnadig

Schwartzberg

et al. 2016

Cancer

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“…Ito et al (2014) reported a randomized phase-2 trial that compared standard antiemetic therapy with a 5-HT3 receptor antagonist and dexamethasone with aprepitant add-on triple antiemetic therapy in patients with NSCLC who received carboplatin-based first-line chemotherapy. The aprepitant group showed a better overall CR of 80.3% compared with that of 67.2% for the control group.…”

Section: Discussionmentioning

confidence: 99%

“…Carboplatin is classified as a MEC agent, but carboplatin-containing combination chemotherapy, such as carboplatin plus pemetrexed, has high emetogenic potential (Ito et al 2014). Antiemetic efficacy may not be satisfactory if only a 5-HT3 receptor antagonist and dexamethasone are administered for prevention of CINV in patients receiving carboplatin-based combination chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of triple antiemetic therapy (palonosetron, dexamethasone, aprepitant) for chemotherapy-induced nausea and vomiting in patients receiving carboplatin-based, moderately emetogenic chemotherapy.

Miya

Kobayashi

Hino

et al. 2016

JCO

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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. Conclusion: Triple antiemetic therapy comprising palonosetron, dexamethasone and aprepitant shows excellent effects in the prevention of CINV in patients receiving a carboplatin-containing regimen.

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“…Various other trials have demonstrated similar results in highly emetic chemotherapy regimens [47,48]. Aprepitant also significantly improved the ability to prevent nausea and vomiting in carboplatin containing regimens when combined with dexamethasone and a 5HT3 receptor antagonist [49][50][51][52]. Aprepitant needs to be combined with dexamethasone and a 5HT3 receptor antagonist to provide maximum efficacy as compared with only aprepitant and dexamethasone, especially in cisplatin based regimens [53].…”

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confidence: 84%

Chemotherapy Induced Nausea and Vomiting: Fear Makes the Wolf Bigger than He is

Sharma¹,

Bajpai²

2017

J Carcinog Mutagen

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Chemotherapy induced nausea and vomiting (CINV) is one of the most feared and severe side effects of cancer treatment. It is broadly categorised as anticipatory (a conditioned reflex, due to past experience, generally triggered by same stimuli), acute (within 24 hours of chemotherapy administration), delayed (after 24 hours and lasting up to 7 days of chemotherapy), breakthrough (inspite of primary prophylaxis for CINV), and refractory (unresponsive to prophylactic and breakthrough medications). The chemotherapeutic regimens are having varying potential (high, moderate, low, or minimal) for CINV. Incidence and timing of CINV depends upon the emetogenic potential of chemotherapy and also patient factors. This perspective highlights the underlying mechanism of CINV, state of the art therapeutic options and nuances in the field to better control this dreaded complication and in turn enhance the quality of life of these patients.

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Aprepitant in patients with advanced non-small-cell lung cancer receiving carboplatin-based chemotherapy

Cited by 62 publications

References 26 publications

Efficacy of the neurokinin‐1 receptor antagonist rolapitant in preventing nausea and vomiting in patients receiving carboplatin‐based chemotherapy

Efficacy of the neurokinin‐1 receptor antagonist rolapitant in preventing nausea and vomiting in patients receiving carboplatin‐based chemotherapy

Efficacy of triple antiemetic therapy (palonosetron, dexamethasone, aprepitant) for chemotherapy-induced nausea and vomiting in patients receiving carboplatin-based, moderately emetogenic chemotherapy.

Chemotherapy Induced Nausea and Vomiting: Fear Makes the Wolf Bigger than He is

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