Evaluation of the effectiveness of aprepitant for prevention of nausea and vomiting in patients with breast cancer

Abstract

Chemotherapy regimen AС (doxorubicin and cyclophosphamide) is the most often used in adjuvant chemotherapy of breast cancer. AC regimen is high emetogenic. Objective – to evaluate the effectiveness of the combination of aprepitant, ondansetron and dexamethasone for the prevention of nausea and vomiting in patients with breast cancer receiving chemotherapy regimen AC. Materials and methods:64 female patients with breast cancer received adjuvant chemotherapy regimen AC: doxorubicin 60 mg/m2, cyclophosphamide 600 mg/m2 in day 1, each 21 day 4 cycle. Patients of Group 1 (n=34) received an triple-therapy regimen ( aprepitant 125 mg p.o. in day 1, 80 mg in days 2 and 3, ondansetron 8 mg i.v. in 1 day, dexamethasone 12 mg i.v.in 1 day, then to 8 mg/day p.o. in days 2–4) for prevention of nausea and vomiting. Patients of Group 2 (n = 30) received ondansetron 8 mg i.v. in 1 day, dexamethasone 12 mg i.v.in 1 day, then to 8 mg/day p.o. in days 2-4). The quality of life of patients was assessed by Functional Living Index of emesis (FLIE). Results: During the first cycle of chemotherapy complete control of nausea and vomiting was achieved at 20 (58,8%) patients of Group 1 and at 4 (13.3%) %) patients of Group 2 (p<0.05). The average score on the Functional Living Index of emesis (FLIE) scale in Group 1 was 19.88, in Group 2-38.03 (p<0.05). Conclusion: Adequate regimen for prevention of nausea and vomiting is combination of NK1 receptor antagonist, 5-HT3 receptor antagonist and dexamethasone.

Keywords

• breast cancer
• chemotherapy regimen (doxorubicin and cyclophosphamide)
• aprepitant
• flie