Abstract
BackgroundRecently, aprepitant has been recommended in carboplatin-based regimens, but there are limited reports on the efficacy of administering aprepitant, palonosetron, and dexamethasone (DEX) in carboplatin-containing regimens. Moreover, because aprepitant is an expensive drug, confirming its effectiveness is very important from the medical cost perspective. In this study, we examined the efficacy of prophylactically administered aprepitant, palonosetron and DEX, in paclitaxel and carboplatin (TC) combination chemotherapy.MethodsPatients with gynecologic cancer who were treated with paclitaxel (175 mg/m2) and carboplatin (area under the curve, AUC = 5–6) combination chemotherapy were retrospectively evaluated. The complete response (CR) rate, severity of nausea, and incidence of anorexia in the first course were compared between patients who did not receive aprepitant (control group) and those who received (aprepitant group).ResultsThe 106 patients were divided into two groups, consisting of 52 and 54 the control and aprepitant groups, respectively, and the patient background showed no significant difference between both groups. The CR rate of the overall phase between the control and aprepitant groups was 73.1 vs. 74.1%, that in the acute phase was 98.1 vs. 100%, and in the delayed phase was 75.0 vs. 74.1%, respectively, without any significant difference. The severity of nausea and incidence of anorexia were also not significantly different between both groups.ConclusionsThe results of the study suggest that adding aprepitant to palonosetron and DEX does not prevent carboplatin-induced nausea and vomiting in gynecologic cancer patients. Therefore, adding aprepitant to palonosetron does not decrease carboplatin-induced nausea and vomiting in patients with gynecologic cancer.
Highlights
Paclitaxel and Carboplatin (TC) combination chemotherapy is regarded as the standard regimen for gynecologic cancer and, is administered to most of these patients [1,2,3,4].Chemotherapy-induced nausea and vomiting (CINV) is one of the most frequent adverse effects, and uncontrolled CINV may limit the dose intensity of chemotherapy and decrease the patient’s quality of life [5,6,7]
Recent guidelines for antiemetic treatments published by the Multinational Association of Supportive Care in Cancer (MASCC), European Society of Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), National Comprehensive Cancer Network (NCCN) and the Japanese Society of Clinical Oncology (JSCO) guidelines for CINV have reclassified carboplatin [10,11,12,13]
The drug has been reported to have the highest CINV risk in patients receiving moderate emetogenic chemotherapy (MEC), and the guidelines suggest the administration of antiemetics according to the recommendations for the highly emetogenic chemotherapy (HEC) classification [10,11,12,13]
Summary
Paclitaxel and Carboplatin (TC) combination chemotherapy is regarded as the standard regimen for gynecologic cancer and, is administered to most of these patients [1,2,3,4]. Chemotherapy-induced nausea and vomiting (CINV) is one of the most frequent adverse effects, and uncontrolled CINV may limit the dose intensity of chemotherapy and decrease the patient’s quality of life [5,6,7] Carboplatincontaining therapies such as TC have been classified as moderate emetogenic chemotherapy (MEC). The drug has been reported to have the highest CINV risk in patients receiving MEC, and the guidelines suggest the administration of antiemetics according to the recommendations for the highly emetogenic chemotherapy (HEC) classification [10,11,12,13]. The complete response (CR) rate, severity of nausea, and incidence of anorexia in the first course were compared between patients who did not receive aprepitant (control group) and those who received (aprepitant group)
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