Ando, Y., Hayashi, T., Ito, K., Suzuki, E., Mine, N., Miyamoto, A., . . . Yamada, S. (2016). Comparison between 5-day aprepitant and single-dose fosaprepitant meglumine for preventing nausea and vomiting induced by cisplatin-based chemotherapy. Supportive Care in Cancer, 24, 871–878. 

DOI Link

Study Purpose

To compare the five-day administration of aprepitant with a single administration of fosaprepitant meglumine to prevent chemotherapy-induced nausea and vomiting (CINV) associated with highly emetogenic chemotherapy regimens containing cisplatin

Intervention Characteristics/Basic Study Process

Participants were randomly assigned to receive a five-day course of aprepitant or a single administration of fosaprepitant meglumine. CINV was monitored for seven days after the first administration of chemotherapy.

Sample Characteristics

  • N = 93
  • MEAN AGE = 63.6 years (range not specified)
  • MALES: 80%, FEMALES: 20%
  • KEY DISEASE CHARACTERISTICS: Gastric cancer, esophageal cancer, lung cancer, or head and neck cancer
  • OTHER KEY SAMPLE CHARACTERISTICS: Highly emetogenic chemotherapy regimens containing cisplatin

Setting

  • SITE: Single site    
  • SETTING TYPE: Not specified    
  • LOCATION: University hospital in Japan

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment

Study Design

Randomized, controlled trial

Measurement Instruments/Methods

  • The Multinational Association of Supportive Care in Cancer (MASCC) Antiemesis Tool (MAT) was used to measure the occurrence of nausea and vomiting. It consisted of a daily review of nausea and vomiting symptoms over seven days.
  • Nausea was measured on a 0–10 scale.
  • Vomiting was measured by the number of vomiting episodes per day.

Results

When CINV was compared, five days of aprepitant versus a single administration of fosaprepitant meglumine did not yield statistically significant results.

Conclusions

Five days of aprepitant for five days and a single administration of fosaprepitant meglumine had similar outcomes in regard to the prevention of CINV.

Limitations

  • Small sample (< 100)

 

Nursing Implications

In this study, one dose of fosaprepitant meglumine had similar effects on CINV as five-day aprepitant. One dose of a medication is more cost effective and reduces patient medication burden, so this may be a preferable treatment alternative.