Abstract
Chemotherapy-induced nausea and vomiting is a challenging issue. Although aprepitant is sometimes used as a therapeutic option in patients receiving moderately emetogenic chemotherapy, the potential benefit of sequential addition of aprepitant to dexamethasone and a 5-hydroxytryptamine-3 (5-HT3) receptor antagonist during the second cycle of carboplatin-based chemotherapy remains unclear. Chemo-naïve patients with advanced non-small cell lung cancer (NSCLC) who received carboplatin-based chemotherapy were treated with doublet antiemetic therapy with dexamethasone and a 5-HT3 receptor antagonist during the first cycle of chemotherapy. Aprepitant was then added during the second cycle of chemotherapy. The primary endpoint was overall complete response rate, defined as no vomiting and no rescue therapy during the 120 h after administration of chemotherapy. Sixty-seven patients were enrolled, 63 of whom were eligible after two cycles of chemotherapy. The overall complete response rate was significantly improved in the second cycle [87.3 %, 95 % confidence interval (CI) 76.5–94.4 %] compared with the first cycle (65.1 %, 95 % CI 52.0–76.7 %; p < 0.001). Improvement was observed in the delayed phase, but not in the acute phase. Subsequent addition of aprepitant significantly improved the overall complete response rate in NSCLC patients receiving a second cycle of carboplatin-based chemotherapy.
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Acknowledgments
This study was supported by research fund from our institution. We would like to thank Edanz [http://www.edanzediting.co.jp] for editing and reviewing this manuscript for English language.
Author contributions
S.S. is the guarantor of the study. S.S and K.M. contributed to the study design, data acquisition and analysis, data interpretation, drafting of the manuscript, critical review, revision and final approval of the manuscript. I.N. contributed to the study design, data analysis and interpretation, drafting of the manuscript, critical review, revision and final approval of the manuscript. S.K., T.F., N.E., Y.N., H.N., K.Y., M.T., S.I., T.S., M.M., T.Y., H.W. and H.H. contributed to the study design, data acquisition and interpretation, critical review, revision and final approval of the manuscript. T.S. contributed to the study design, data interpretation, critical review, revision and final approval of the manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Suzuki, S., Karayama, M., Inui, N. et al. Sequential addition of aprepitant in patients receiving carboplatin-based chemotherapy. Med Oncol 33, 65 (2016). https://doi.org/10.1007/s12032-016-0780-6
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DOI: https://doi.org/10.1007/s12032-016-0780-6