Combination of aprepitant, palonosetron and dexamethasone as antiemetic prophylaxis in lung cancer patients receiving multiple cycles of cisplatin-based chemotherapy
| Autor: | Giovanni Mansueto, Daniela Adua, V. Lapadula, Silvia Quadrini, G. Del Bene, Erminio Bonizzoni, Flavia Longo, L. Stumbo, L. De Filippis |
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| Rok vydání: | 2012 |
| Předmět: |
Cisplatin
medicine.medical_specialty Chemotherapy Original Paper medicine.drug_class Nausea business.industry medicine.medical_treatment Palonosetron General Medicine Gastroenterology Oncology Internal medicine Anesthesia medicine Vomiting Antiemetic medicine.symptom business Dexamethasone Aprepitant medicine.drug |
| Zdroj: | International Journal of Clinical Practice |
| ISSN: | 1742-1241 |
| Popis: | SUMMARY Introduction: With repeated courses of chemotherapy, chemotherapy-induced nausea and vomiting (CINV) becomes progressively more difficult to control. The aim of this study was to evaluate whether the antiemetic efficacy of the triple combination aprepitant, palonosetron and dexamethasone could be sustained for up to six cycles of highly emetogenic chemotherapy (HEC) (cisplatin ‡ 50 mg ⁄m 2 ). Methods: Chemotherapy-naive patients receiving cisplatin-based HEC, were trea- ted with palonosetron 0.25 mg ⁄i.v., dexamethasone 20 mg ⁄i.v. and aprepitant 125 mg ⁄p.o. 1 h before chemotherapy. Aprepitant 80 mg ⁄p.o. and dexametha- sone 4 mg ⁄p.o. were administered on days 2-3. The primary endpoint was com- plete response (CR, no vomiting and no use of rescue medication), over 5 days following HEC in up to six cycles. Secondary endpoints were emesis-free and nau- sea-free rates. Safety was also evaluated. Results: One hundred and fifty six lung cancer patients were included in the study; the median age was 64 years and 76.9% were men. The minimum cisplatin dosage was 75 mg ⁄m 2 , and in most patients was combined with another drug (87.4%). CR ranged from 74.4% (first cycle) to 82% (sixth cycle). More than 90% and 60% of patients were emesis-free and nausea-free during all chemotherapy cycles. The most commonly reported side effects were constipation and headache. Conclusions: The triple combination of aprepitant, palonosetron and dexamethasone enhanced not only the antiemetic protection during the first cycle, but its efficacy was also sustained for up to six cycles of cisplatin-based HEC in lung cancer patients. What's known It is already known that palonosetron and aprepitant are efficacious to prevent nausea and vomiting induced in patients receiving high emetogenic chemotherapy. The efficacy of a triple combination palonosetron, aprepitant and dexamethasone to prevent CINV has been assessed only during one chemotherapy cycle (the first). |
| Databáze: | OpenAIRE |
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