Fosaprepitant for the prevention of nausea and vomiting in patients receiving BEAM or high-dose melphalan before autologous hematopoietic stem cell transplant

Clark, Scott G.; Clemmons, Amber B.; Schaack, Lindsay; Garren, Jeonifer; DeRemer, David L.; Kota, Vamsi

doi:10.1177/1078155215585190

Cited by 5 publications

(13 citation statements)

References 30 publications

(75 reference statements)

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“…Eleven papers, reporting results of clinical trials, that explored the effectiveness of a certain prophylaxis for CINV in patients undergoing HDMel conditioning for autologous SCT are included (Table 1). Of these 11 studies, 2 are randomized, comparative, and prospective [7,18], 6 are single-arm prospective [7,12,15,16,18,20], 2 are comparative and retrospective [10,19], and 1 is single-arm retrospective [13] ( Table 1). From these experiments, only aprepitant, fosaprepitant, and olanzapine were compared to standard therapy in the setting of HDMel.…”

Section: Efficacy Of Combination Antiemetic Therapymentioning

confidence: 99%

“…The study by Clark SM et al [18] compared a three-drug regimen, which was administered prospectively, to a historical cohort of patients treated with a two-drug regimen. The threedrug (Fos) aprepitant-containing treatment was more effective when compared to the two-drug 5HT3RA + dexamethasone regimen (see, Table 1).…”

Section: Efficacy Of Combination Antiemetic Therapymentioning

confidence: 99%

“…The six noncomparative, single-arm, prospective studies [7,12,15,16,18,20] investigated the efficacy of an aprepitant-containing three-drug regimen (four studies [12,15,16,20]), a fosaprepitant-containing three-drug regimen (one study [18]), and a palonosetron-containing two-drug regimen (one study [7]). The results disclosed a high probability of protection from emesis with rescue medication (80-88%) and a lower, although different between trials, probability of protection from emesis without rescue medication (0-52%).…”

Section: Efficacy Of Combination Antiemetic Therapymentioning

confidence: 99%

“…5HT3RA 5HT3RAs are recommended by guidelines for CINV prophylaxis in autologous SCT, as well as for highly emetogenic drugs as part of a three-drug combination (aprepitant + 5HT3RA + dexamethasone) [4,8,9]. In the setting of HDMel, palonosetron was investigated in five trials [7,11,13,15,20], granisetron in three trials [12,17,19], and ondansetron in three trials [14,16,18]. The efficacy of different 5HT3RA drugs was not evaluated in the setting of HDMel; therefore, they should perhaps be considered equivalent in terms of efficacy for CINV prevention.…”

Section: Drug-focused Overviewmentioning

confidence: 99%

“…Aprepitant and Fosaprepitant As for 5HT3RA, NK1RAs are recommended for CINV prophylaxis in autologous SCT and highly emetogenic chemotherapy in combination with 5HT3RA and dexamethasone. In the setting of HDMel, aprepitant or fosaprepitant were investigated in eight different trials [12,[14][15][16][17][18][19][20]. Two trials compared a three-drug regimen (aprepitant or fosaprepitant +5HT3 + dexamethasone) with a two-drug regimen (5HT3RA + dexamethasone), concluding that the three-drug regimen was more effective [16,17].…”

Section: Drug-focused Overviewmentioning

confidence: 99%

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Prevention of chemotherapy-induced nausea and vomiting after high-dose melphalan and stem cell transplantation: review of the evidence and suggestions

Tendas

Marchesi²,

Mengarelli³

et al. 2018

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Introduction High-dose melphalan (HDMel) is the most common conditioning chemotherapy regimen for autologous stem cell transplantation (SCT) in patients affected by multiple myeloma (MM). No consensus exists for the emetogenicity or prophylaxis of chemotherapy-induced nausea and vomiting (CINV) in this regimen. Methods Data on the incidence and efficacy/safety of CINV prophylaxis among patients affected by MM undergoing autologous SCT with the HDMel regimen was extracted from electronic databases and analyzed. Results Eleven studies involving multiple CINV prophylaxis regimens were identified and included. No consensus on HDMel emetogenicity was reached, but most studies summarized the emetogenicity as moderate-high risk. An aprepitant-based threedrug regimen (aprepitant + serotonin receptor antagonist (5HT3RA) + dexamethasone) showed better efficacy than a two-drug regimen (5HT3RA + dexamethasone) for CINV prevention without increasing the frequency in adverse events. Conclusions The aprepitant-based three-drug regimen should be the regimen of choice for CINV prophylaxis for MM patients undergoing autologous SCT with HDMel conditioning. Keywords Chemotherapy-induced nausea and vomiting. Stem cell transplantation. High-dose melphalan. Aprepitant. Quality of life * Andrea Tendas

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Section: Efficacy Of Combination Antiemetic Therapymentioning

confidence: 99%

Section: Efficacy Of Combination Antiemetic Therapymentioning

confidence: 99%

Section: Efficacy Of Combination Antiemetic Therapymentioning

confidence: 99%

Section: Drug-focused Overviewmentioning

confidence: 99%

Section: Drug-focused Overviewmentioning

confidence: 99%

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Prevention of chemotherapy-induced nausea and vomiting after high-dose melphalan and stem cell transplantation: review of the evidence and suggestions

Tendas

Marchesi²,

Mengarelli³

et al. 2018

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Antiemetic prophylaxis in patients undergoing hematopoietic stem cell transplantation: a multicenter survey of the Gruppo Italiano Trapianto Midollo Osseo (GITMO) transplant programs

et al. 2020

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A survey within hematopoietic stem cell transplant (HSCT) centres of the Gruppo Italiano Trapianto Midollo Osseo (GITMO) was performed in order to describe current antiemetic prophylaxis in patients undergoing HSCT. The multicentre survey was performed by questionnaire, covering the main areas on chemotherapy induced nausea and vomiting (CINV): antiemetic prophylaxis guidelines used, antiemetic prophylaxis in different conditioning regimens, methods of CINV evaluation. The survey was carried out in November 2015 [before the publication of the Multinational Association of Supportive Care in Cancer (MASCC)/ European Society for Medical Oncology (ESMO) specific guidelines on antiemetic prophylaxis in HSCT] and its was repeated six months later. The results show a remarkable heterogeneity of prophylaxis among the various centers and a significant difference between the guidelines and the clinical practice. In the main conditioning regimens, the combination of a serotonin3 receptor antagonist (5-HT3-RA) with dexamethasone and neurokin1 receptor antagonist (NK1-RA), as recommended by MASCC/ESMO guidelines, increased from 0-14% (before the publication of the guidelines) to 10-25% (after the publication of the guidelines). This study shows a lack of compliance with specific antiemetic guidelines, resulting mainly in under-prophylaxis. Concerted strategies are required to improve the current CINV prophylaxis, to draft shared common guidelines and to increase the knowledge and the adherence to the current recommendations for CINV prophylaxis in the specific field of HSCT.

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Netupitant/palonosetron without dexamethasone for preventing nausea and vomiting in patients with multiple myeloma receiving high-dose melphalan for autologous stem cell transplantation: a single-center experience

Loteta

Paviglianiti

Naso

et al. 2021

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Chemotherapy-induced nausea and vomiting (CINV) is one of the most frequent adverse events compromising quality of life (QoL) in patients undergoing autologous stem cell transplantation (ASCT). However, CINV prophylaxis is still lacking uniformity for high-dose melphalan (HDM), which is used to condition patients with multiple myeloma (MM). Netupitant/palonosetron (NEPA) is administered with dexamethasone (DEXA) for CINV prevention in several chemotherapy regimens. Our study aims to assess the efficacy of NEPA, without DEXA, in preventing CINV in 106 adult patients with MM receiving HDM and ASCT. All patients had antiemetic prophylaxis with multiple doses of NEPA 1 h before the start of conditioning and after 72 h and 120 h. A complete response (CR) was observed in 99 (93%) patients at 120 h (overall phase). The percentage of patients with complete control was 93%. The CR rate during the acute phase was 94% ( n = 100). During the delayed phase, the CR rate was 95% ( n = 101). Grade 1 nausea and vomiting were experienced by 82% and 12% of the patients, respectively. Grade 2 nausea was reported in 18% and vomiting in 10% of patients. Our results showed, for the first time, that NEPA, without DEXA, was a well-tolerated and effective antiemetic option for MM patients receiving HDM followed by ASCT. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06472-7.

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Fosaprepitant for the prevention of nausea and vomiting in patients receiving BEAM or high-dose melphalan before autologous hematopoietic stem cell transplant

Abstract: Further studies are suggested to investigate the optimal number and timing of doses of fosaprepitant in this setting.

Cited by 5 publications

References 30 publications

Prevention of chemotherapy-induced nausea and vomiting after high-dose melphalan and stem cell transplantation: review of the evidence and suggestions

Prevention of chemotherapy-induced nausea and vomiting after high-dose melphalan and stem cell transplantation: review of the evidence and suggestions

Antiemetic prophylaxis in patients undergoing hematopoietic stem cell transplantation: a multicenter survey of the Gruppo Italiano Trapianto Midollo Osseo (GITMO) transplant programs

Netupitant/palonosetron without dexamethasone for preventing nausea and vomiting in patients with multiple myeloma receiving high-dose melphalan for autologous stem cell transplantation: a single-center experience

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