Suzuki, S., Karayama, M., Inui, N., Kuroishi, S., Fujisawa, T., Enomoto, N., . . . Suda, T. (2016). Sequential addition of aprepitant in patients receiving carboplatin-based chemotherapy. Medical Oncology, 33, 65-016-0780-6.
To evaluate the safety and efficacy of the addition of aprepitant in patients receiving carboplatin-based chemotherapy after initial doublet-based antiemetics in the first chemotherapy cycle
In the first cycle of chemotherapy, patients were receiving doublet therapy, consisting of a 5-HT3 and dexamethasone. In the second cycle, patients received aprepitant and reduced dexamethasone, as in standard triplet regimens. Patients completed daily questionnaires regarding vomiting frequency, nausea scoring, and food intake for five days of each cycle.
The overall (p < 0.001) and delayed phase (p < 0.001) CR rates were better in the second cycle with the addition of aprepitant. No difference existed in the CR rates in the acute phase. Fewer patients in the second cycle required rescue antiemetics (p = 0.006). The proportion of patients who had grade 2 or higher nausea was less in the cycle with aprepitant (p = 0.013).
The addition of aprepitant significantly improved CINV control.
This study showed that the addition of an NK1 as salvage for patients on MEC who did not have complete control in initial chemotherapy cycles was associated with improved CINV control, particularly in the delayed phase.