529P Exploratory study for preventing nausea and vomiting by switching from pranisetron + dexamethasone (Days 1-3) + aprepitant (Days 1-3) to palonosetron + pexamethasone (Day 1) in patients undergoing moderatelyemetogenic chemotherapy

Abstract

Background A combination of aprepitant, a 5-HT3 receptor antagonist, and dexamethasone is recommended for the prophylaxis of acute or delayed emesis induced by chemo therapy containing L-OHP (oxaliplatin) or CPT-11 (irinotecan) in patients with colorectal cancer. This study aimed to evaluate the prevention of nausea and vomiting by switching from Granisetron + Dexamethasone (Days 1-3) + Aprepitant (Days 1-3) to Palonosetron + Dexamethasone (Day 1)—which is the preventive treatment used in MEC therapy—in colorectal cancer (CRC) patients undergoing L-OHP or CPT-11 chemotherapy. Methods In this study, patients who had colorectal cancer and were being treated with L-OHP or CPT-11 chemotherapy were switched from Granisetron + Dexamethasone (Days 1-3) + Aprepitant (Days 1-3) to Palonosetron + Dexamethasone (Day 1). Before chemotherapy, all patients were treated with intravenous granisetron (1 mg), dexamethasone(6.6mg), and oral a prepitant (125mg). On days 2 and 3, patients received oral dexamethasone (4 mg) and aprepitant (80 mg) once daily. For the next chemotherapy course, all patients were treated with intravenous palonosetron (0.75 mg) and dexamethasone (9.9 mg). On days 2 and 3, patients did not receive oral dexamethasone. The primary end point was the rate of complete response (i.e., no vomiting) from days 2 to 5 after chemotherapy. Results Thirty-two patients who had received LOHP or CPT-11 chemotherapy between April 2016 and June 2016 agreed to participate in this study. Day 1: Complete response rates were similar: 78.1% for palonosetron and 81.3% for aprepitant (P < 0.739). Days 2 to 5: Complete response rates were also similar: 62.5% for palonosetron and 68.8% for aprepitant (P < 0.527). The overall complete response rates were similar: 56.3% for palonosetron and 65.6% for aprepitant (P < 0.366). Conclusions Switching from Granisetron þ Dexamethasone (Days 1–3) þ Aprepitant (Days 1–3) to Palonosetron þ Dexamethasone (Days 1) - which is the preventive treatment used in MEC therapy - had a similar effect on preventing nausea and vomiting in CRC patients undergoing L-OHP or CPT-11 chemotherapy. Clinical trial indentification UMIN000021593 Legal entity responsible for the study Iwate Medical University School of Medicine Funding Iwate Medical University School of Medicine Disclosure All authors have declared no conflicts of interest.