Molassiotis, A., Nguyen, A.M., Rittenberg, C.N., Makalinao, A., & Carides, A. (2013). Analysis of aprepitant for prevention of chemotherapy-induced nausea and vomiting with moderately and highly emetogenic chemotherapy. Future Oncology (London, England), 9(10), 1443–1450.
Phase III clinical trial program; included data from two HEC trials and one MEC trial
More patients who received the aprepitant regimen in the HEC trials achieved overall complete response compared with those on standard antiemetic therapy in cycle one adjusted for gender, region, and use of concomitant chemotherapy (67.7% versus 47.8%, p < 0.01). A significantly higher number of patients who received aprepitant reported NIDL (74.4%) as compared with those on the standard antiemetic regimen (63.9%, p < 0.01). In the HEC group, when compared to standard therapy, patients who received aprepitant reported significantly lower nausea (70.2% versus 60.9%) and vomiting (84.6% versus 68.7%, p < 0.01). In the MEC trial, reports of no emesis were significantly lower in the aprepitant group (76.2%) than in the standard regimen (61.1%, p < 0.001) after the first cycle of chemotherapy. Patients receiving aprepitant in the MEC trial had a significantly higher percentage of complete response (68.7%) than the patients in the standard regimen (56.3%, p < 0.001). Aprepitant also had a significant impact on patient report of NIDL with 73.4% reporting no impact compared to 66.3% in the standard regimen group (p < 0.05).
Aprepitant, when given with HEC, led to higher overall complete response rates than the standard regimen. Patients who received aprepitant and MEC also reported lower levels of nausea and vomiting. For patients receiving both HEC and MEC, aprepitant improved outcomes on activities of daily living (ADL).
Aprepitant, in addition to standard CINV prophylactic medications, reduces nausea and vomiting associated with chemotherapy and decreases the impact of CINV on ADLs. This is true for patients receiving HEC and MEC. Nurses should spend time educating patients on how CINV can impact ADLs and work with patients to create patient-centered, nurse-led interventions to ease the influence of CINV on patient quality of life.