• Lung Cancer · Jun 2014

    Randomized Controlled Trial

    Aprepitant in patients with advanced non-small-cell lung cancer receiving carboplatin-based chemotherapy.

    • Yasuhiro Ito, Masato Karayama, Naoki Inui, Shigeki Kuroishi, Hideki Nakano, Yutaro Nakamura, Koshi Yokomura, Mikio Toyoshima, Toshihiro Shirai, Masafumi Masuda, Takashi Yamada, Kazumasa Yasuda, Hiroshi Hayakawa, Takafumi Suda, and Kingo Chida.
    • Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan.
    • Lung Cancer. 2014 Jun 1; 84 (3): 259-64.

    ObjectivesChemotherapy-induced nausea and vomiting (CINV) is an unanswered problem in cancer therapy. We evaluated the efficacy and safety of triple antiemetic therapy with aprepitant, a 5-hydroxytryptamine-3 (5-HT(3)) receptor antagonist, and dexamethasone in patients with advanced non-small-cell lung cancer (NSCLC) who received carboplatin-based first-line chemotherapy.MethodsChemotherapy-naïve patients with NSCLC were enrolled in this randomized phase-II study. Patients were randomized to standard antiemetic therapy with a 5-HT(3) receptor antagonist and dexamethasone, and aprepitant add-on triple antiemetic therapy. The primary endpoint was the complete response rate (no vomiting and no rescue therapy) during the 120 h post-chemotherapy.ResultsA total of 134 patients were assigned randomly to the aprepitant group or the control group. The aprepitant group and the control group showed an overall complete response rate of 80.3% (95% confidence interval (CI), 69.2-88.1%) and 67.2% (95% CI, 55.3-77.2%; odds ratio (OR), 0.50; 95% CI, 0.22-1.10; p = 0.085), respectively. Among patients taking carboplatin and pemetrexed, adding aprepitant significantly improved the complete response rate in the overall phase (83.8% in the aprepitant group and 56.8% in the control group; OR, 0.26; 95% CI, 0.08-0.70; p < 0.01) and the delayed phase (86.5% in the aprepitant group and 59.1% in the control group; OR, 0.23; 95% CI, 0.07-0.65; p < 0.01).ConclusionCarboplatin-based chemotherapy has considerable emetic potential. Triple antiemetic therapy with aprepitant, a 5-HT(3) receptor antagonist, and dexamethasone improved the control of CINV prevention in patients receiving carboplatin and pemetrexed chemotherapy.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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