Aprepitant for management of severe pruritus related to biological cancer treatments: a pilot study

Santini, Daniele; Vincenzi, Bruno; Guida, Francesco; Imperatori, Marco; Schiavon, Gaia; Venditti, Olga; Frezza, Anna Maria; P, Berti; Tonini, Giuseppe

doi:10.1016/s1470-2045(12)70373-x

Cited by 109 publications

(82 citation statements)

References 19 publications

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“…However, according to the results of a recent clinical pilot study, it seems that aprepitant decreases severe pruritus induced by biological cancer treatments. No adverse events related to aprepitant were observed (Santini et al 2012) (Table 3). Moreover, aprepitant decreased the average daily number of micturitions in subjects with urge incontinence (Green et al 2006) (Table 3).…”

Section: Therapy With Nk-1 Receptor Antagonists In Human Pathologymentioning

confidence: 98%

Involvement of substance P and the NK-1 receptor in human pathology

2014

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The peptide substance P (SP) shows a widespread distribution in both the central and peripheral nervous systems, but it is also present in cells not belonging to the nervous system (immune cells, liver, lung, placenta, etc.). SP is located in all body fluids, such as blood, cerebrospinal fluid, breast milk, etc. i.e. it is ubiquitous in human body. After binding to the neurokinin-1 (NK-1) receptor, SP regulates many pathophysiological functions in the central nervous system, such as emotional behavior, stress, depression, anxiety, emesis, vomiting, migraine, alcohol addiction, seizures and neurodegeneration. SP has been also implicated in pain, inflammation, hepatitis, hepatotoxicity, cholestasis, pruritus, myocarditis, bronchiolitis, abortus, bacteria and viral infection (e.g., HIV infection) and it plays an important role in cancer (e.g., tumor cell proliferation, antiapoptotic effects in tumor cells, angiogenesis, migration of tumor cells for invasion, infiltration and metastasis). This means that the SP/NK-1 receptor system is involved in the molecular bases of many human pathologies. Thus, knowledge of this system is the key for a better understanding and hence a better management of many human diseases. In this review, we update the involvement of the SP/NK-1 receptor system in the physiopathology of the above-mentioned pathologies and we suggest valuable future therapeutic interventions involving the use of NK-1 receptor antagonists, particularly in the treatment of emesis, depression, cancer, neural degeneration, inflammatory bowel disease, viral infection and pruritus, in which that system is upregulated.

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Section: Therapy With Nk-1 Receptor Antagonists In Human Pathologymentioning

confidence: 98%

Involvement of substance P and the NK-1 receptor in human pathology

2014

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“…In severe cases, all of the above should be used and the patient should be referred to a dermatologist to optimize the treatment. A pilot study showed promising results in severe pruritus for the off-label use of aprepitant [4]. …”

Section: Xerosis and Pruritusmentioning

confidence: 99%

Prophylaxis and Management of Skin Toxicities

2019

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Skin toxicity is a common problem not only when treating breast cancer but in all cancer types. Visible on the surface, these side effects come not just with burdening symptoms but also with stigmatization. With increasing diversity in therapeutic options, dermatologic side effects are also becoming increasingly complex and more challenging for the clinician. We reviewed the most common dermatologic side effects of current anticancer therapy, including toxicity induced by chemotherapy, targeted therapy, and immunotherapy. In particular, we focus on xerosis and pruritus, (acneiform) exanthema, hand-foot syndrome, nail toxicities, alopecia, and mucositis. We propose measures for the prevention and management of these side effects based on current literature. With high incidences in both chemotherapy and targeted therapy, prophylactic measures are crucial to reducing the incidence and severity of skin toxicity and therefore key to therapy adherence. Appropriate management of these toxicities will help avoid unnecessary treatment discontinuation.

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“…The anti-emetic aprepitant has been shown to reduce the severity of pruritus almost eight-fold (Santini et al, 2012).…”

Section: Additional Side Effectsmentioning

confidence: 99%