Joseph S Bubalo1, Jon D Herrington2, Marc Takemoto3, Patricia Willman4, Michael S Edwards5, Casey Williams6, Alan Fisher7, Alison Palumbo8, Eric Chen7, Charles Blanke1, Charles D Lopez1. 1. Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. 2. Scott & White Medical Center - Temple, Texas A&M College of Medicine, 2401 South 31st Street, Temple, TX, 76508, USA. 3. Kaiser Permanante, Oncology Clinic - Moanalua Medical Center, 3288 Moanalua Road, Honolulu, HI, 96789, USA. 4. St. Joseph's/Candler, Lewis Cancer Center and Research Pavilion, 225 Candler Dr., Savannah, GA, 31405, USA. 5. Edwards Global Pharmaceutical Consulting, 4620 N. Park Ave Unit 1680E, Chevy Chase, MD, 20815, USA. 6. Avera Center for Precision Oncology and Department of Molecular and Medicine, 1000 E 23rd St, Suite 200, Sioux Falls, SD, 57105, USA. 7. Ingalls Memorial Hospital, One Ingalls Dr., Harvey, IL, 60426, USA. 8. Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. palumbo@ohsu.edu.
Abstract
PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) causes significant morbidity among colorectal cancer patients, receiving fluorouracil, oxaliplatin, and leucovorin (FOLFOX) chemotherapy even with standard antiemetic prophylaxis. The purpose of this study is to determine if the addition of aprepitant to standard antiemetic therapy improves CINV in these patients. METHODS: Patients receiving FOLFOX for colorectal cancer were given antiemetic prophylaxis with aprepitant 125 mg orally on day 1 and 80 mg on days 2 and 3. Palonosetron 0.25 mg was given IV push on day 1 only. Dexamethasone 12 mg was administered orally on day 1 and 8 mg each morning on days 2 through 4. Assessments including emetic events, rescue doses, nutritional intake, and appetite were recorded in a patient diary which was returned to study personnel in the following cycle. RESULTS: Of the 53 patients screened, 50 were evaluable and had a complete dataset for cycle 1. For the first cycle, 74% of patients achieved a complete response (CR), 22% achieved a major response and 4% experienced treatment failure. The percentage of patients achieving a CR remained high throughout each cycle at 83, 83, and 86% for cycles 2, 3, and 4, respectively. Appetite and nutritional status remained largely unchanged throughout treatment. Adverse events occurring in more than 10% of patients included diarrhea (13.6%), fatigue (12.6%), and neutropenia (11%). CONCLUSIONS: Aprepitant added to standard antiemetic therapy appears to be an effective and safe regimen for prevention of CINV in patients receiving FOLFOX.
PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) causes significant morbidity among colorectal cancerpatients, receiving fluorouracil, oxaliplatin, and leucovorin (FOLFOX) chemotherapy even with standard antiemetic prophylaxis. The purpose of this study is to determine if the addition of aprepitant to standard antiemetic therapy improves CINV in these patients. METHODS:Patients receiving FOLFOX for colorectal cancer were given antiemetic prophylaxis with aprepitant 125 mg orally on day 1 and 80 mg on days 2 and 3. Palonosetron 0.25 mg was given IV push on day 1 only. Dexamethasone 12 mg was administered orally on day 1 and 8 mg each morning on days 2 through 4. Assessments including emetic events, rescue doses, nutritional intake, and appetite were recorded in a patient diary which was returned to study personnel in the following cycle. RESULTS: Of the 53 patients screened, 50 were evaluable and had a complete dataset for cycle 1. For the first cycle, 74% of patients achieved a complete response (CR), 22% achieved a major response and 4% experienced treatment failure. The percentage of patients achieving a CR remained high throughout each cycle at 83, 83, and 86% for cycles 2, 3, and 4, respectively. Appetite and nutritional status remained largely unchanged throughout treatment. Adverse events occurring in more than 10% of patients included diarrhea (13.6%), fatigue (12.6%), and neutropenia (11%). CONCLUSIONS:Aprepitant added to standard antiemetic therapy appears to be an effective and safe regimen for prevention of CINV in patients receiving FOLFOX.
Authors: Paul J Hesketh; Steven M Grunberg; Richard J Gralla; David G Warr; Fausto Roila; Ronald de Wit; Sant P Chawla; Alexandra D Carides; Juliana Ianus; Mary E Elmer; Judith K Evans; Klaus Beck; Scott Reines; Kevin J Horgan Journal: J Clin Oncol Date: 2003-10-14 Impact factor: 44.544
Authors: Marziyeh Ghorbani; Mehdi Dehghani; Noushin Fahimfar; Soha Namazi; Ali Dehshahri Journal: Support Care Cancer Date: 2022-01-17 Impact factor: 3.603