Abstract
5593 Background: Aprepitant is an NK-1 antagonist that reduces delayed nausea and vomiting (N&V) in pts receiving high-dose (HD) cisplatin. Single-agent HD cisplatin 100 mg/m2 iv q3weeks × 3 doses concurrent with RT is a standard curative regimen for LA SCCHN. In Oct 2007, aprepitant was approved for use in Canada and immediately entered clinical use. We examined treatment delivery and health resource use in pts with LA SCCHN, before and after the introduction of aprepitant. Methods: LA SCCHN pts receiving HD cisplatin (>=70mg/m2) with curative intent Jan 2006-Jan 2009 were identified and data extracted including use of aprepitant, >=grade 2 N&V, hospitalization, chemotherapy delivery, and mortality. Outcomes in pts were compared pre- and post-Oct 2007. Results: HD cisplatin was administered 453 times (212 pre-/241 post-) in 179 pts (89 pre-/90 post-). Pts were similar pre- and post- with exception of more stage 4B disease treated post- (9 vs. 22%, p=0.02). HD cisplatin + RT was used in 202 treatments (95%) pre- vs. 186 (77%) post-; neoadjuvant docetaxel/cisplatin/5-FU (TPF) was used in 9 (4%) pre- vs. 55 (23%) post- (p<0.001). Aprepitant was used in 0% pre- and 82% post-. Rates of nausea and vomiting diminished (35 vs. 22%, 15 vs. 5%; p<0.001), more pts completed 2 and 3 cycles of HD cisplatin (85 vs. 96%, 53 vs. 72%; p<0.05) and 1 year mortality improved (21 vs. 8%, p=0.01) post-Oct 2007. Overall hospitalization and length of stay increased (43 vs. 52%, 5.9 vs. 7.3 days) due to admissions for administration and complications of neoadjuvant TPF. Conclusions: Most LA SCCHN pts treated with HD cisplatin received aprepitant once it was available. After the introduction of aprepitant, a greater proportion of pts were free of nausea or vomiting and completed planned chemotherapy. Despite increased use of multi-agent neoadjuvant chemotherapy and a higher proportion of pts with stage IVB disease treated, more pts were alive at 1 year in the post-aprepitant era. Although these retrospective data cannot prove causality, they suggest beneficial effects of aprepitant that allow improved treatment delivery by reducing treatment toxicity. No significant financial relationships to disclose.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
