Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference

Roila, Fausto; Herrstedt, Jørn; Aapro, Matti; Gralla, Richard J.; Einhorn, Lawrence H.; Ballatori, Enzo; Bria, Emilio; Clark‐Snow, Rebecca; Espersen, B.T.; Feyer, Petra; Grunberg, Steven M.; Hesketh, Paul J.; Jordan, Karin; Kris, Mark G.; Maranzano, Ernesto; Molassiotis, Alex; Morrow, Gary R.; Olver, Ian; Rapoport, Bernardo; Rittenberg, Cynthia N.; Saito, Mitsue; Tonato, Maurizio; Warr, David

doi:10.1093/annonc/mdq194

Cited by 617 publications

(557 citation statements)

References 28 publications

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“…The MEC category includes chemotherapeutic agents with an emetic potential ranging from 30% to 90% 4, 6. Carboplatin, a second‐generation platinum analog, has an emetic potential greater than that of many agents classified as MEC 4, 7.…”

Section: Introductionmentioning

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: Introductionmentioning

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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“…It is known that in chemotherapy regimens including more than one drug, the degree of emetogenicity is given by the combination of the chemotherapy drug with the highest emetogenic degree, plus the degree of emetogenicity of the other drugs. (9) The management of emesis, particularly at the late stage of post chemotherapy, is a challenge. (12) It is known that first-generation 5-HT3 antagonists such as the ondansetron, which is the drug used in most cycles evaluated in this study, often fails to adequately control the late symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…(9) In the data analysis, three groups of patients were formed in accordance with the routine use of antiemetics at home: (1) Regular: use according to medical prescription, following the prescribed dosage; (2) Irregular: use without obeying the association of antiemetics and/or the recommended dosage, and (3) Self-medication: addition of some antiemetic to their everyday use, as well as using what had been prescribed or using only the antiemetic that they considered as the most effective.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of antiemetics in control of antineoplastic chemotherapy-induced emesis at home

et al. 2014

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Objective: Evaluating if antiemetics are effective in the prevention or treatment at home, of chemotherapyinduced emesis. Methods: In total, were included 42 women with breast cancer in moderately emetogenic chemotherapy, using dexamethasone/ondansetron before each cycle. The frequency of nausea and vomiting was obtained by applying the instrument in the pre-chemotherapy period, and 24h, 48h, 72h and 96h after chemotherapy. The use of antiemetics was considered in accordance with adherence to medical prescription. Results: All patients (n = 42, 100%) reported emesis at some point. Only five cases (11.9%) were anticipatory. In the first 24 hours (acute emesis), 38 (90.5%)ayed), emesis was reported by all despite the regular use (n = 20, 47.6%) or not (n = 22, 52.4%) of antiemetics (ondansetron, dexamethasone and metoclopramide/or dimenhydrinate). Conclusion: Antiemetics were not effective in the prevention or treatment at home, of chemotherapy-induced emesis. ResumoObjetivo: Avaliar se antieméticos são eficazes na prevenção ou tratamento da emese induzida pela quimioterapia antineoplásica, em domicílio. Métodos: Foram incluídas 42 mulheres com câncer de mama, em quimioterapia moderadamente emetogênica, submetidas à dexametasona/ondansetrona antes de cada ciclo. A frequência de náuseas e vômitos foi obtida por instrumento aplicado nos tempos pré-quimioterapia e 24h, 48h, 72h e 96h pós-quimioterapia. O uso de antieméticos foi considerado conforme adesão à prescrição médica. Resultados: Todas as pacientes (n=42, 100%) relataram emese em algum momento. Apenas cinco casos (11,9%) foram antecipatórios. Nas primeiras 24h (emese aguda), 38 (90,5%) apresentaram náuseas associadas (n=20, 47,6%) ou não (n=18, 42,8%) a vômitos e, após este período (tardio), a emese foi referida por todas, apesar da utilização regular (n=20, 47,6%) ou não (n=22, 52,4%) de antieméticos (ondansetrona, dexametasona, metoclopramida e/ou dimenidrinato). Conclusão: Os antieméticos não foram eficazes na prevenção ou no tratamento da emese induzida pela quimioterapia, em domicílio.

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“…The oral neurokinin-1 receptor antagonist aprepitant is an antiemetic drug with a new mechanism of action that not only shows efficacy for acute CINV (within 24 hours of starting chemotherapy) but also for delayed CINV (24 hours or more after starting chemotherapy), which is poorly controlled by current therapies, and the efficacy of aprepitant against the emetic effect of singledose cisplatin has been demonstrated (Roila et al, 2010;Basch et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…We employ a daily cisplatin regimen (FP therapy with daily administration of cisplatin at 20mg/m 2 from Day 1 to Day 4 and 5-fluorouracil (5-FU) at 400 mg/m 2 from Day 1 to Day 5) (Brizel et al, 1998) to treat patients with head and neck cancer (HNC), but there have been few studies on the efficacy of aprepitant during daily administration of cisplatin and no specific antiemetic regimen for daily cisplatin therapy has been established (Roila et al, 2010;Basch et al, 2011;Einhorn et al, 2011). When FP therapy is performed at our department, severe nausea tends to occur on or after the last day of cisplatin administration and it has a strong impact on quality of life (Sun et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Aprepitant for Nausea in Patients with Head and Neck Cancer Receiving Daily Cisplatin Therapy

Ishimaru

Takano²,

Katsura³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Although efficacy of aprepitant for suppressing emesis associated with single-dose cisplatin has been demonstrated, there are limited data on the antiemetic effect of this oral neurokinin-1 receptor antagonist during daily administration of cisplatin. Accordingly, we investigated the efficacy and safety of aprepitant in patients with head and neck cancer (HNC) receiving combination therapy with cisplatin and 5-FU (FP therapy). Materials and Methods: Twenty patients with HNC were prospectively studied who received a triple antiemetic regimen comprising granisetron (40μg/kg on Days 1-4), dexamethasone (8 mg on Days 1-4), and aprepitant (125 mg on day 1 and 80mg on days 2-5) with FP therapy (cisplatin 20 mg/m 2 on days 1-4; 5-FU 400 mg/m 2 on days 1-5) (aprepitant group). We also retrospectively studied another 20 HNC patients who received the same regimen except for aprepitant (control group). Results: For efficacy endpoints based on nausea, the aprepitant group showed significantly better results, including a higher rate of complete response (no vomiting and no salvage therapy) for the acute phase (p=0.0342), although there was no marked difference between the two groups with regard to percentage of patients in whom vomiting was suppressed. There were no clinically relevant adverse reactions to aprepitant. Conclusions: This study suggested that a triple antiemetic regimen containing aprepitant is safe and effective for HNC patients receiving daily cisplatin therapy.

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Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference

Cited by 617 publications

References 28 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

Effectiveness of antiemetics in control of antineoplastic chemotherapy-induced emesis at home

Efficacy of Aprepitant for Nausea in Patients with Head and Neck Cancer Receiving Daily Cisplatin Therapy

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