Paul J Hesketh1, Pedro Sanz-Altamira. 1. Department of Hematology Oncology, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA. Paul.Hesketh@Lahey.org
Abstract
PURPOSE: This study evaluated the efficacy and tolerability of aprepitant, dexamethasone, and palonosetron in the prevention of nausea and vomiting in breast cancer patients receiving their initial cycle of doxorubicin and cyclophosphamide (AC). METHODS: Patients with breast cancer, ≥ age 18, with a performance status of ≤ 2, receiving doxorubicin (≥ 60 mg/m(2)) and cyclophosphamide (≥ 500 mg/m(2)) for the first time were eligible. Prior to chemotherapy patients received aprepitant 125 mg orally (PO), dexamethasone 8-10 mg PO/intravenously (IV), and palonosetron 0.25 mg IV. On days 2-3, dexamethasone 4 mg PO and aprepitant 80 mg PO were given. Outcomes were recorded in patient diaries for the 120-h study period following chemotherapy. Primary endpoint was the proportion of patients achieving complete response (no emesis or rescue) for the 120-h study period. RESULTS: Thirty-six patients were enrolled and all are evaluable. The median age was 53 (33-75) and 36 are females. Eighteen patients (50%) achieved a complete response during the 120-h study period. Acute (≤ 24 h) and delayed (24-120 h) complete response rates were 81% (27/36) and 61% (22/36), respectively. No emesis rates for the acute, delayed, and overall study periods were 97% (35/36), 94% (34/36), and 92% (33/36), respectively. Treatment was well tolerated. CONCLUSIONS: The combination of aprepitant, dexamethasone, and palonosetron prevented emesis in more than 90% of breast cancer patients receiving their initial cycle of AC chemotherapy. Nausea was less well controlled. Overall complete response was achieved in one half of the study patients. Further improvement in the prevention of AC-induced chemotherapy-induced nausea and vomiting will require more effective antinausea treatments.
PURPOSE: This study evaluated the efficacy and tolerability of aprepitant, dexamethasone, and palonosetron in the prevention of nausea and vomiting in breast cancerpatients receiving their initial cycle of doxorubicin and cyclophosphamide (AC). METHODS:Patients with breast cancer, ≥ age 18, with a performance status of ≤ 2, receiving doxorubicin (≥ 60 mg/m(2)) and cyclophosphamide (≥ 500 mg/m(2)) for the first time were eligible. Prior to chemotherapy patients received aprepitant 125 mg orally (PO), dexamethasone 8-10 mg PO/intravenously (IV), and palonosetron 0.25 mg IV. On days 2-3, dexamethasone 4 mg PO and aprepitant 80 mg PO were given. Outcomes were recorded in patient diaries for the 120-h study period following chemotherapy. Primary endpoint was the proportion of patients achieving complete response (no emesis or rescue) for the 120-h study period. RESULTS: Thirty-six patients were enrolled and all are evaluable. The median age was 53 (33-75) and 36 are females. Eighteen patients (50%) achieved a complete response during the 120-h study period. Acute (≤ 24 h) and delayed (24-120 h) complete response rates were 81% (27/36) and 61% (22/36), respectively. No emesis rates for the acute, delayed, and overall study periods were 97% (35/36), 94% (34/36), and 92% (33/36), respectively. Treatment was well tolerated. CONCLUSIONS: The combination of aprepitant, dexamethasone, and palonosetron prevented emesis in more than 90% of breast cancerpatients receiving their initial cycle of AC chemotherapy. Nausea was less well controlled. Overall complete response was achieved in one half of the study patients. Further improvement in the prevention of AC-induced chemotherapy-induced nausea and vomiting will require more effective antinausea treatments.
Authors: F Roila; J Herrstedt; M Aapro; R J Gralla; L H Einhorn; E Ballatori; E Bria; R A Clark-Snow; B T Espersen; P Feyer; S M Grunberg; P J Hesketh; K Jordan; M G Kris; E Maranzano; A Molassiotis; G Morrow; I Olver; B L Rapoport; C Rittenberg; M Saito; M Tonato; D Warr Journal: Ann Oncol Date: 2010-05 Impact factor: 32.976
Authors: P J Hesketh; M G Kris; S M Grunberg; T Beck; J D Hainsworth; G Harker; M S Aapro; D Gandara; C M Lindley Journal: J Clin Oncol Date: 1997-01 Impact factor: 44.544
Authors: R Gralla; M Lichinitser; S Van Der Vegt; H Sleeboom; J Mezger; C Peschel; G Tonini; R Labianca; A Macciocchi; M Aapro Journal: Ann Oncol Date: 2003-10 Impact factor: 32.976
Authors: Peter Eisenberg; Jazmin Figueroa-Vadillo; Rosalio Zamora; Veena Charu; Julio Hajdenberg; Alan Cartmell; Alberto Macciocchi; Steven Grunberg Journal: Cancer Date: 2003-12-01 Impact factor: 6.860
Authors: Steven M Grunberg; Matthew Dugan; Hyman Muss; Marie Wood; Susan Burdette-Radoux; Tracey Weisberg; Marisa Siebel Journal: Support Care Cancer Date: 2008-11-27 Impact factor: 3.603
Authors: Meinolf Karthaus; Csőszi Tibor; Vito Lorusso; Rajender Singh-Arora; Alexander Filippov; Giada Rizzi; Maria Elisa Borroni; Giorgia Rossi; Steven M Grunberg Journal: Support Care Cancer Date: 2015-02-28 Impact factor: 3.603
Authors: Michelle Zhou; Marko Popovic; Mark Pasetka; Natalie Pulenzas; Soha Ahrari; Edward Chow; Carlo DeAngelis Journal: Ther Clin Risk Manag Date: 2015-05-05 Impact factor: 2.423
Authors: Muhammad Qamar; Ghulam Abbas; Muhammad Afzaal; Muhammad Y Naz; Abdul Ghuffar; Muhammad Irfan; Stanislaw Legutko; Jerzy Jozwik; Magdalena Zawada-Michalowska; Abdulnour Ali Jazem Ghanim; Saifur Rahman; Usama M Niazi; Mohammed Jalalah; Fahad Salem Alkahtani; Mohammad K A Khan; Ewelina Kosicka Journal: Materials (Basel) Date: 2022-02-26 Impact factor: 3.623
Authors: Luigi Celio; Erminio Bonizzoni; Filippo De Braud; Francesco Agustoni; Matti Aapro Journal: Support Care Cancer Date: 2015-08-06 Impact factor: 3.603