Antiemetic Efficacy of Adding Olanzapine 5 mg to Aprepitant, Palonosetron and Dexamethasone-Sparing After Day Two for Cancer Patients Receiving Anthracycline and Cyclophosphamide
Autor: | Yuka Ito, Koichiro Tsugawa, Marii Suehiro, Masaki Takahashi, Kiwako Ikegawa, Tsuneaki Tanaka, Takayuki Keira, Yasuyuki Kojima, Hiroko Minatogawa |
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Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
medicine.medical_specialty Nausea medicine.drug_class medicine.medical_treatment chemotherapy induced nausea and vomiting Gastroenterology 03 medical and health sciences breast cancer 0302 clinical medicine Internal medicine medicine Antiemetic Aprepitant Original Research Chemotherapy highly emetogenic chemotherapy business.industry Palonosetron Regimen antiemetics 030104 developmental biology Oncology Cancer Management and Research 030220 oncology & carcinogenesis Vomiting medicine.symptom business medicine.drug Chemotherapy-induced nausea and vomiting |
Zdroj: | Cancer Management and Research |
ISSN: | 1179-1322 |
Popis: | Marii Suehiro,1,* Yasuyuki Kojima,2,* Masaki Takahashi,3,* Yuka Ito,4 Takayuki Keira,1 Kiwako Ikegawa,1 Hiroko Minatogawa,1 Koichiro Tsugawa,2 Tsuneaki Tanaka1 1Department of Pharmacy, St. Marianna University School of Medicine Hospital, Kawasaki-shi, Kanagawa, 216-8511, Japan; 2Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine Hospital, Kawasaki-shi, Kanagawa, 216-8511, Japan; 3Division of Medical Informatics, St. Marianna University School of Medicine Hospital, Kawasaki-shi, Kanagawa, 216-8511, Japan; 4Department of Pharmacy, Kawasaki Municipal Tama Hospital, Kawasak-shi, Kanagawa, 214-8525, Japan*These authors contributed equally to this workCorrespondence: Marii SuehiroDepartment of Pharmacy, St. Marianna University School of Medicine Hospital, 2-16-1 Sugao, Miyamae-Ku, Kawasaki-shi, Kanagawa, 216-8511, JapanTel +81-44-977-8111Fax +81-44-975-0608Email marii-fujita@marianna-u.ac.jpPurpose: Chemotherapy-induced nausea and vomiting (CINV) decrease patientquality of life (QOL). We evaluated the efficacy of adding 5 mg Olz to a three-drug steroid-sparing antiemetic regimen (aprepitant, palonosetron, and dexamethasone-sparing after day two) for breast cancer (BC) patients receiving anthracycline plus cyclophosphamide (AC) chemotherapy.Patients and Methods: We retrospectively reviewed the records of 177 BC patients with no previous highly emetogenic chemotherapy history receiving AC plus the steroid-sparing three-drug regimen or the steroid-sparing four-drug regimen including Olz 5mg at our hospital between January 2012 and December 2018. The primary endpoint was complete response (CR), defined as no vomiting and no usage of rescue medication during the first AC cycle. We analyzed the odds ratio (OR) of the CR with 95% confidence interval (CI) in the three-drug group against the four-drug group. The OR was adjusted for types of anticancer drugs by the Cochran–Mantel–Haenszel (CMH) test. Secondary endpoints were incidences of nausea, anorexia, fatigue, and somnolence during the first cycle.Results: Compared to the three-drug group, the four-drug group demonstrated high incidence of no vomiting (71% vs 95%), a similar incidence of no rescue medication usage (50% vs 51%), and a similar CR rate (45% vs 49%). The OR of the CR rate in the three-drug group against the four-drug group after CMH adjustment for drug type was 0.958 (95% CI, 0.46– 1.98). Compared to the three-drug group, the four-drug group demonstrated identical incidence of nausea (66%), but lower incidences of anorexia (78% vs 35%) and fatigue (86% vs 73%). The incidence of somnolence in the four-drug group was 49%. We did not have data of somnolence for the three-drug group in the records.Conclusion: Adding 5 mg Olz to the steroid-sparing three-drug combination can reduce vomiting, anorexia, and fatigue, although there was no difference in CR rate.Keywords: breast cancer, highly emetogenic chemotherapy, chemotherapy induced nausea and vomiting, antiemetics |
Databáze: | OpenAIRE |
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