Olver, I.N., Grimison, P., Chatfield, M., Stockler, M.R., Toner, G.C., Gebski, V., … Australian and New Zealand Urogenital and Prostate Cancer Trials Group. (2013). Results of a 7-day aprepitant schedule for the prevention of nausea and vomiting in 5-day cisplatin-based germ cell tumor chemotherapy. Supportive Care in Cancer , 21, 1561-1568.doi: 10.1007/s00520-012-1696-0
To determine the effectiveness of the addition of a seven-day aprepitant dose to standard triple-drug antiemetic therapy for patients receiving multiday, highly emetogenic chemotherapy (HEC)
Patients were given 125 mg of oral apreipitant on day 1 and 80 mg of apreipitant on days 2-7, a 5-HT3 on days 1-5, and 8 mg of dexamethasone on 1-8 for each cycle of chemotherapy. Assessment of efficacy was performed via daily diaries, and analysis of outcomes was done for each chemotherapy cycle. Rescue medication was lorazepam, metoclopramide, haloperideol, or prochlorperazine.
The study was conducted at a single outpatient site in Austalia.
This was a prospective, observational trial.
Patients recorded the number of vomiting episodes and severity of nausea and an 11-point numeric scale in diaries.
This study adds to the current evidence for effectiveness of triple-drug antiemetic therapy for patients receiving HEC. The findings suggested that additional days of neurokinin 1 (NK1) may improve outcomes. The findings showed that nausea continues to be poorly controlled with current regimens.
Triple-drug antiemetic therapy for patients receiving HEC is the current established recommendation for management of chemotherapy-induced nausea and vomiting (CINV). The addition of further NK1 may improve control. Although current therapies appear to control vomiting well, nausea continues to be a problem for patients. Ongoing research aimed at nausea control is needed.