A randomized study of aprepitant, ondansetron and dexamethasone for chemotherapy-induced nausea and vomiting in Chinese breast cancer patients receiving moderately emetogenic chemotherapy

Abstract

The aprepitant regimen appears to reduce the requirement of rescue medication when compared with the control regimen for prevention of CINV in patients receiving both an anthracycline and cyclophosphamide, and is associated with a better quality of life during adjuvant AC chemotherapy.

Chemotherapy-Induced Nausea and Vomiting: Time for More Emphasis on Nausea?

“…Not surprisingly, aprepitant-containing regimens have become the standard recommendation at many institutions, and aprepitant use has soared. Has this optimism from both patients and physicians significantly improved patient care?Despite the significant improvements in CINV reported in the aprepitant trials, control of CINV-and nausea in particular-remains suboptimal in patients receiving anthracycline and cyclophosphamide-based regimens [7,8]. In the nontrial setting, ∼58%-71% of patients will have nausea and/or vomiting despite "optimal" antiemetic prescribing (C. Hernandez-Torres, personal communication) [9].…”

Controlling Chemotherapy-Induced Nausea and Vomiting with Neurokinin-1 Receptor Antagonists in Patients on AC-Based Chemotherapy—Are We There Yet?

“…receive a course of MEC for the treatment of a solid malignant tumor. Four APR RCTs [12,19,21,22], 1 APR OS [20] and 1 CAS RCT [11] required patients to be on AC-based or AC-only chemotherapy. One CAS RCT and 1 APR OS included patients on other MECs such as fluorouracil, oxaliplatin [18], irinotecan [17,18], carboplatin, idarubicin, ifosfamide, mitoxantrone and ≤50 mg/m 2 of cisplatin [17].…”

“…However, in the APR RCT by Warr et al [21], patients were allowed to take single daily doses of lorazepam in the 48 hours preceding chemotherapy. Excluded patients in these studies were those with etiology known to increase CINV risk, such as active infections [12,17,18,21,22], any uncontrolled disease [12,17,18,21,22], symptomatic primary or metastatic central nervous system malignancy [12,18,21], alcohol abuse, use of illicit drugs, mental incapacitation, significant emotional or psychiatric disorder or hypersensitivity to 5HT 3 -RAs or dexamethasone [11,22]. As the NK1-RAs (e.g.…”

“…To minimize the contribution of anticipatory nausea and vomiting to CINV, 6 studies excluded patients who experienced nausea or vomiting in the 24 hours preceding chemotherapy [12,17,18,[20][21][22]. Both APR OSs [17,20] specifically stated the use of the National Cancer Institute Common Toxicity Criteria (Version 3) [24], which was not mentioned in the other 4 studies [12,18,21,22].…”

“…Both APR OSs [17,20] specifically stated the use of the National Cancer Institute Common Toxicity Criteria (Version 3) [24], which was not mentioned in the other 4 studies [12,18,21,22]. The study by Hesketh et al [20] excluded patients who experienced nausea greater or equal to Grade 1, while that of Grote et al [17] only excluded patients who had experienced nausea corresponding to Grade 2 or 3.…”