Aprepitant Plus Granisetron and Dexamethasone for Prevention of Chemotherapy-induced Nausea and Vomiting in Patients with Gastric Cancer Treated with S-1 Plus Cisplatin

Overview

Journal J Gastroenterol

Specialty Gastroenterology

Date 2013 Jan 23

PMID 23338487

Citations 8

Authors

Katsunobu Oyama

Sachio Fushida

Masahide Kaji

Toshiya Takeda

Shinichi Kinami

Yasuo Hirono

Katsuhiro Yoshimoto

Kazuhisa Yabushita

Hisashi Hirosawa

Yuki Takai

Tatsuo Nakano

Hironobu Kimura

Toshiaki Yasui

Atsushi Tsuneda

Tomoya Tsukada

Jun Kinoshita

Takashi Fujimura

Tetsuo Ohta

Affiliations

Soon will be listed here.

Abstract

Background: We aimed to evaluate the efficacy of a new combination antiemetic therapy comprising aprepitant, granisetron, and dexamethasone in gastric cancer patients undergoing chemotherapy with cisplatin and S-1.

Methods: Gastric cancer patients scheduled to receive their first course of chemotherapy with cisplatin (60 mg/m(2)) and S-1 (80 mg/m(2)) were treated with a new combination antiemetic therapy aprepitant, granisetron, and dexamethasone on day 1; aprepitant and dexamethasone on days 2 and 3; and dexamethasone on day 4. The patients reported vomiting, nausea, use of rescue therapy, and change in the amount of diet intake, and completed the Functional Living Index-Emesis (FLIE) questionnaire. The primary endpoint was complete response (CR; no emesis and use of no rescue antiemetics) during the overall study phase (0-120 h after cisplatin administration). The secondary endpoints included complete protection (CP; CR plus no significant nausea); change in the amount of diet intake; and the impact of chemotherapy-induced nausea and vomiting (CINV) on daily life during the overall, acute (0-24 h), and delayed (24-120 h) phases.

Results: Fifty-three patients were included. CR was achieved in 88.7, 98.1, and 88.7% of patients in the overall, acute, and delayed phases, respectively. The corresponding rates of CP were 67.9, 96.2, and 67.9%. Approximately half of the patients had some degree of anorexia. FLIE results indicated that 79.5% of patients reported "minimal or no impact of CINV on daily life".

Conclusions: Addition of aprepitant to standard antiemetic therapy was effective in gastric cancer patients undergoing treatment with cisplatin and S-1.

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