阿瑞匹坦预防高致吐性化疗所致恶心呕吐的效果和安全性评价

doi:10.13481/j.1671-587x.20160227

Abstract

Abstract:

Objective: To explore the efficacy and safety of aprepitant combined with tropisetron and dexamethasone in the prevention of emetogenic chemotherapy-induced nausea and vomiting and clarify its influence in the life guality of patients, and to evaluate its safety in treatment.Methods: One hundred and fifty six patients with malignant tumor were randomly assigned to observation group (n=75)(day 1, aprepitant 125 mg, tropisetron 4 mg and dexamethasone 6 mg 1 h before chemotherapy, day 2-4, aprepitant 80 mg and dexamethasone 3.75 mg, qd) and control group (n=81) (day 1, tropisetron 4 mg and dexamethasone 6 mg before chemotherapy, day 2-4, dexamethasone 3.75 mg, qd). The primary study endpoints were the comparisons of acute and delayed complete response rates of nausea and vomiting, and the second study endpoints were the evaluations on the improvement of the life quality of patients.Results: General evaluation on the primary study endpoints was performed, The complete remission rate in observation group was 69.3%(52/75), and the complete remission rate in control group was 53.1%(43/81), there was signficant difference between two groups(P=0.049). For the acute nausea and vomiting(0-24 h), the complete remission rate in observation group was 78.7%(59/75), and the complete remission rate in control group was 75.3%(61/81), and there was no significant difference between two groups(P=0.705). The complete remission rate of delayed nausea and vomiting(25-120 h) in observation group was significantly higher than that in control group (76.0% vs 54.3%)(P=0.007). For the second study endpoints, the average scores of FLIE in observation and control group were 120.8±12.4 and 84.0±8.7, and there was significant difference between two groups(P<0.05).Conclusion: Aprepitant can significantly prevent the emetogenic chemotherapy-induced nausea and vomitting and improve the life quality of patients.

Key words: aprepitan, highly emetogenic chemotherapy, nausea and vomiting, neurokinin-1

CLC Number:

R730.53

MENG Wenjing, WANG Xu, JIA Yongsheng, TONG Zhongsheng. Efficacy and safety evaluation on aprepitant in prevention of nausea and vomiting induced by highly emetogenic chemotherapy[J].Journal of Jilin University Medicine Edition, 2016, 42(02): 331-335.

References

[1] Badar T, Cortes J, Borthakur G, et al. Phase Ⅱ, open label, randomized comparative trial of ondansetron alone versus the combination of ondansetron and aprepitant for the prevention of nausea and vomiting in patients with hematologic malignancies receiving regimens containing high-dose cytarabine[J]. Biomed Res Int, 2015, 2015:497597.

[2] Jahn F, Riesner A, Jahn P, et al. Addition of the neurokinin-1-receptor antagonist (RA) aprepita nt to a 5-hydroxy tryptamine-RA and dexametha sone in the prophylaxis of nausea and vomiting due to radiation therapy with concomitant cisplatin[J]. Int J Radiat Oncol Biol Phys, 2015, 92(5):1101-1107.

[3] Kawaguchi R, Tanase Y, Haruta S, et al. Addition of aprepitant to standard therapy for prevention of nausea and vomiting among patients with cervical cancer undergoing concurrent chemoradiotherapy[J].Int J Gynaecol Obstet, 2015,131(3):312-313.

[4] Rapoport BL. Efficacy of a triple antiemetic regimen with aprepitant for the prevention of chemotherapy-induced nausea and vomiting:effects of gender, age, and region[J]. Curr Med Res Opin, 2014,30(9):1875-1881.

[5] Schmitt T, Goldschmidt H, Neben K, et al. Aprepitant, granisetron, and dexamethasone for prevention of chemotherapy-induced nausea and vomiting after high-dose melphalan in autologous transplantation for multiple myeloma:Results of a randomized, placebo-controlled phase Ⅲ trial[J]. J Clin Oncol, 2014, 32(30):3413-3420.

[6] Hingmire S, Raut N. Open-label observational study to assess the efficacy and safety of aprepitant for chemotherapy-induced nausea and vomiting prophylaxis in Indian patients receiving chemotherapy with highly emetogenic chemotherapy/moderately emetogenic chemotherapy regimens[J]. South Asian J Cancer, 2015, 4(1):7-10.

[7] Erickson BK, Martin JY, Shah MM, et al. Reasons for failure to deliver National Comprehensive Cancer Network (NCCN)-adherent care in the treatment of epithelial ovarian cancer at an NCCN cancer center[J]. Gynecol Oncol, 2014, 133(2):142-146.

[8] Hu Z, Cheng Y, Zhang H, et al. Aprepitant triple therapy for the prevention of chemotherapy-induced nausea and vomiting following high-dose cisplatin in Chinese patients:A randomized, double-blind, placebo-controlled phase Ⅲ trial[J]. Support Care Cancer, 2014, 22(4):979-987.

[9] Wang SY, Yang ZJ, Zhang Z, et al. Aprepitant in the prevention of vomiting induced by moderately and highly emetogenic chemotherapy[J]. Asian Pac J Cancer Prev, 2014, 15(23):10045-10051.

[10] Gao HF, Liang Y, Zhou NN, et al. Aprepitant plus palonosetron and dexamethasone for prevention of chemotherapy-induced nausea and vomiting in patients receiving multiple-day cisplatin chemotherapy[J]. Intern Med J, 2013, 43(1):73-76.

[11] Aapro MS, Schmoll HJ, Jahn F, et al. Review of the efficacy of aprepitant for the prevention of chemotherapy-induced nausea and vomiting in a range of tumor types[J]. Cancer Treat Rev, 2013, 39(1):113-117.

[12] Nakayama Y, Ito Y, Tanabe M, et al. A combination of aprepitant, palonosetron, and dexamethasone prevents emesis associated with anthracycline-containing regimens for patients with breast cancer. A retrospective study[J]. Breast Cancer, 2015, 22(2):177-184.

[13] Choi CH, Kim MK, Park JY, et al. Safety and efficacy of aprepitant, ramosetron, and dexamethasone for chemotherapy-induced nausea and vomiting in patients with ovarian cancer treated with paclitaxel/carboplatin[J]. Support Care Cancer, 2014, 22(5):1181-1187.

[14] Takeshima N, Matoda M, Abe M, et al. Efficacy and safety of triple therapy with aprepitant, palonosetron, and dexamethasone for preventing nausea and vomiting induced by cisplatin-based chemotherapy for gynecological cancer:KCOG-G1003 phase Ⅱ trial[J]. Support Care Cancer, 2014,22(11):2891-2898.

Efficacy and safety evaluation on aprepitant in prevention of nausea and vomiting induced by highly emetogenic chemotherapy

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