Incidence of chemotherapy-induced nausea and vomiting associated with docetaxel and cyclophosphamide in early breast cancer patients and aprepitant efficacy as salvage therapy. Results from the Spanish Breast Cancer Group/2009-02 study

Autor: Fernando Salvador Moreno, Laura Murillo, Luis A. Fernández-Morales, Carlos Jara-Sanchez, Ana González, Mª del Mar Angulo, Vicente Carañana, Manuel Ramos, Mª Isabel Casas, José A. García-Sáenz, Antonio Llombart-Cussac, Ana I. Garcia-Mace, Xavier González-Farré, Serafin Morales, Elsa Dalmau, Lourdes Calvo, Mª Carmen Cámara, Eva Carrasco
Rok vydání: 2015
Předmět:
Cancer Research
Time Factors
Salvage therapy
Docetaxel
Dexamethasone
0302 clinical medicine
Surveys and Questionnaires
Antineoplastic Combined Chemotherapy Protocols
Secondary Prevention
Serotonin 5-HT3 Receptor Antagonists
030212 general & internal medicine
Prospective Studies
Aprepitant
Aged
80 and over
Nausea
Middle Aged
Treatment Outcome
Oncology
030220 oncology & carcinogenesis
Female
Taxoids
medicine.symptom
medicine.drug
Adult
medicine.medical_specialty
medicine.drug_class
Vomiting
Morpholines
Breast Neoplasms
03 medical and health sciences
Breast cancer
Internal medicine
medicine
Antiemetic
Humans
Cyclophosphamide
Aged
Neoplasm Staging
Salvage Therapy
business.industry
medicine.disease
Surgery
Regimen
Spain
Quality of Life
Antiemetics
business
Chemotherapy-induced nausea and vomiting
Zdroj: European journal of cancer (Oxford, England : 1990). 58
ISSN: 1879-0852
Popis: Background Docetaxel–cyclophosphamide (TC) has become a common regimen in moderate-high-risk early breast cancer (EBC), but the incidence of chemotherapy-induced nausea and vomiting (CINV) with this regimen is not well established. This trial investigates the effect of guideline-consistent prophylaxis on CINV related to TC regimen and explores the efficacy of aprepitant among resistant patients. Patients and Methods This prospective multicentre study enrolled 212 chemotherapy-naive EBC patients receiving T-75 mg/m 2 and C-600 mg/m 2 . Antiemetic therapy on the first cycle consisted of dexamethasone for 3 d plus 5-hydroxytryptamine (5-HT 3 ) antagonists on day 1, according to Multinational Association of Supportive Care in Cancer guidelines. The primary end-point was complete response (CR) (no emesis and no need of rescue treatment within the initial 120 h). Patients failing CR on cycle 1 entered in a single-arm study exploring the efficacy of aprepitant on the second cycle. Patients' diaries and Functional Living Index-Emesis (FLIE) questionnaires were collected in cycles 1 and 2. Results Among the 185 evaluable patients on cycle 1, 161 (87%, 95% confidence interval [CI]: 82.2–91.8) achieved a CR. Twenty-three patients received aprepitant on cycle 2, and 12 reached a CR (52.2%, 95% CI: 31.8–72.6). The absence of CR had a very substantial impact on quality of life on cycles 1 (FLIE before and after: 23.8–38.1, p = 0.0124) and 2 (18.3–42.9, p = 0.0059). Conclusions Guideline-consistent antiemetic prophylaxis for the TC regimen is associated with a low incidence of CINV. Aprepitant is effective as secondary prevention of CINV and should be considered as rescue therapy in patients treated with moderate emetogenic chemotherapy.
Databáze: OpenAIRE
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