Duggin, K., Tickle, K., Norman, G., Yang, J., Wang, C., Cross, S.J., . . . Mandrell, B. (2014). Aprepitant reduces chemotherapy-induced vomiting in children and young adults with brain tumors. Journal of Pediatric Oncology Nursing, 31, 277–283.
To determine if a 5HT3 receptor antagonist and aprepitant, an NK1 antagonist, without a corticosteroid were effective in reducing vomiting in pediatric patients with brain tumors receiving highly emetogenic chemotherapy (HEC)
This retrospective chart review investigated all patients (young adults and children) receiving the medulloblastoma protocol who were prescribed a 5HT3 antagonist plus aprepitant without a corticosteroid during their first course of HEC from September 9, 2003 to March 12, 2010. All cases were matched with two controls who received 5HT3 plus a corticosteroid.
Single-institution retrospective chart review
The control group experienced grade 2 or higher chemotherapy-induced vomiting when compared to aprepitant recipients. When controlling for variables such as risk, age, and gender, patients who did not receive aprepitant were significantly more likely to have grade 2 or higher vomiting during the first course of HEC than aprepitant recipients.
There is limited literature documenting chemotherapy-induced nausea and vomiting among pediatric patients, and this study provides helpful information to investigate the role of aprepitant. Prospective studies including patient-reported outcomes would be helpful in characterizing the benefits of aprepitant. The ability to better control chemotherapy-induced nausea and vomiting without the use of steroids is very beneficial.