Effect of Aprepitant for the Prevention of Chemotherapy-Induced Nausea and Vomiting in Women

Abstract

Key Points Question Is prophylactic aprepitant therapy combined with palonosetron and dexamethasone effective in preventing nausea and vomiting in women receiving moderately emetogenic chemotherapy? Findings In this randomized phase 3 clinical trial that included 248 women younger than 50 years with no or little alcohol use, the complete response rate in the overall phase for chemotherapy-induced nausea and vomiting was 87% in the aprepitant group vs 67% in the control group. The overall complete response rate was significantly higher in the aprepitant group vs the control group. Meaning Adding aprepitant to palonosetron and dexamethasone was effective in reducing nausea and vomiting for women who received moderately emetogenic chemotherapy.

The Effectiveness of an Oral Fixed-Dose Combination of Netupitant and Palonosetron (NEPA) in Patients With Multiple Risk Factors for Chemotherapy-Induced Nausea and Vomiting: A Multicenter, Observational Indian Study

“…There was no difference in CR when we compared the current subgroup analysis complete response to the primary study population (86.21% versus 85.41%) [ 8 ]. The effect of aprepitant-palonosetron-dexamethasone on high-risk CINV patients of the female gender, young age (<50 years), little or no alcohol intake, and first chemotherapy cycle showed CR of 87%, 92.7%, and 88.6% in overall, acute, and delayed phases, respectively, which was consistent with our study [ 18 ]. Another study found that the aprepitant-ondansetron-dexamethasone had a CR of 68% in patients with high-risk factors (such as female gender, age (<65 years), and little or no alcohol intake) in the overall phase, which was lower than the current study [ 19 ].…”

Aprepitant plus palonosetron versus dexamethasone plus palonosetron in preventing chemotherapy-induced nausea and vomiting in patients with moderate-emetogenic chemotherapy: A randomized, open-label, phase 3 trial

“…A recent prospective study has demonstrated that the combination of aprepitant with palonosetron and dexamethasone provided antiemetic efficacy in women patients with high-risk vomiting undergoing FOLFOX or FOLFIRI chemotherapy regimen. 23 However, all these studies contained dexamethasone in the antiemetic regimen. Indeed, our results showed the combination of aprepitant with palonosetron significantly improves antiemetic efficiency than the combination of dexamethasone with palonosetron in the mFOLFOX6 chemotherapy regimen.…”

Pooled analysis of combination antiemetic therapy for chemotherapy-induced nausea and vomiting in patients with colorectal cancer treated with oxaliplatin-based chemotherapy of moderate emetic risk

“…In addition, the randomized trial in Chinese female patients with gastrointestinal cancer at high risk for CINV (younger than 50 years, no or low alcohol consumption) demonstrated significantly better antiemetic effect of 3 antiemetics, palonosetron plus dexamethasone plus aprepitant, compared with palonosetron plus dexamethasone for CINV caused by L-OHP or irinotecan-based chemotherapy [ 33 ].…”