Research Article| Volume 45, ISSUE 7, P1184-1187, May 2009

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Safety and efficacy of a triple antiemetic combination with the NK-1 antagonist aprepitant in highly and moderately emetogenic multiple-day chemotherapy

Published:January 09, 2009DOI:


      Aim of the study

      In multiple-day chemotherapy (MDC), the combination of a 5-HT3-antagonist plus dexamethasone is still a standard of care. The role of a NK-1-antagonist remains to be defined.

      Patients and methods

      Seventy eight cancer patients undergoing multiple-day chemotherapy of high (HEC) or moderate (MEC) emetic risk received granisetron, dexamethasone plus aprepitant during chemotherapy. After the end of chemotherapy, aprepitant plus dexamethasone was given for another 2 days. Primary end-point was complete response (CR) in the overall phase (day 1 until 5 days after the end of chemotherapy).


      Thirty eight patients underwent HEC and 40 patients underwent MEC for a median of 3.5 days. CR was seen in 57.9% and 72.5% of patients receiving HEC and MEC, respectively. The tolerability of the aprepitant regimen over 5–7 days was comparable with a 3-day aprepitant regimen.


      This is the first report in MDC with a NK-1-antagonist containing antiemetic regimen showing a favourable safety profile with good antiemetic efficacy.


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        • Kris M.G.
        • Hesketh P.J.
        • Somerfield M.R.
        • et al.
        American Society of Clinical Oncology guideline for antiemetics in oncology: update 2006.
        J Clin Oncol. 2006; 24: 2932-2947
        • Roila F.
        • Hesketh P.J.
        • Herrstedt J.
        Prevention of chemotherapy- and radiotherapy-induced emesis: results of the 2004 Perugia International Antiemetic Consensus Conference.
        Ann Oncol. 2006; 17: 20-28
        • Jordan K.
        • Schmoll H.J.
        • Aapro M.S.
        Comparative activity of antiemetic drugs.
        Crit Rev Oncol Hematol. 2007; 61: 162-175
        • Fox S.M.
        • Einhorn L.H.
        • Cox E.
        • Powell N.
        • Abdy A.
        Ondansetron versus ondansetron, dexamethasone, and chlorpromazine in the prevention of nausea and vomiting associated with multiple-day cisplatin chemotherapy.
        J Clin Oncol. 1993; 11: 2391-2395
        • Weissbach L.
        Lancet. 1991; 338: 753-754
        • Einhorn L.H.
        • Brames M.J.
        • Dreicer R.
        • et al.
        Palonosetron plus dexamethasone for prevention of chemotherapy-induced nausea and vomiting in patients receiving multiple-day cisplatin chemotherapy for germ cell cancer.
        Support Care Cancer. 2007; 15: 1293-1300
        • Forni C.
        • Ferrari S.
        • Loro L.
        • et al.
        Granisetron, tropisetron, and ondansetron in the prevention of acute emesis induced by a combination of cisplatin-Adriamycin and by high-dose ifosfamide delivered in multiple-day continuous infusions.
        Support Care Cancer. 2000; 8: 131-133
        • Hesketh P.J.
        • Grunberg S.M.
        • Gralla R.J.
        • et al.
        The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin – the Aprepitant Protocol 052 study group.
        J Clin Oncol. 2003; 21: 4112-4119
        • Schmoll H.J.
        • Aapro M.S.
        • Poli-Bigelli S.
        • et al.
        Comparison of an aprepitant regimen with a multiple-day ondansetron regimen, both with dexamethasone, for antiemetic efficacy in high-dose cisplatin treatment.
        Ann Oncol. 2006; 17: 1000-1006
        • Durand J.P.
        • Gourmel B.
        • Mir O.
        • Goldwasser F.
        Antiemetic neurokinin-1 antagonist aprepitant and ifosfamide-induced encephalopathy.
        Ann Oncol. 2007; 18: 808-809