The use of aprepitant in the first cycle of moderately emetogenic chemotherapy in patients with colorectal cancer: its preventive effect on chemotherapy-induced nausea and vomiting

Abstract

Purpose: There have been fever studies about the effectiveness of aprepitant in the first cycle of moderately emetogenic chemotherapy. The aim of this study was to determine whether aprepitant shows the effectiveness for prevention of chemotherapy-induced nausea and vomiting in the first cycle of moderately emetogenic chemotherapy in colon cancer patients. Methods: A total of 131 patients who received their first chemotherapy (FOLFOX4, mFOLFOX6, or FOLFIRI regimen) for colon cancer were retrospectively analyzed. Eighty-one patients received aprepitant, 5HT3-receptor antagonist and dexamethasone (aprepitant group) and 50 patients received 5HT3-receptor antagonist and dexamethasone without aprepitant (control group) in the first cycle of moderately emetogenic chemotherapy. We compared the outcomes of the response and the incidence of adverse events. Results: Both groups were similar in baseline characteristics. The complete response rate was significantly higher in the aprepitant group during 24 hours postchemotherapy (98.8% vs. 90.0%, P=0.02), between 24 to 120 hours postchemotherapy (96.3% vs. 86.0%, P=0.031), and during the 120 hours postchemotherapy (96.3% vs. 82.0%, P=0.006). The overall incidence of adverse events was similar between the aprepitant and the control group as 30% vs. 26%, respectively. Conclusion: The use of aprepitant combination with 5HT3-receptor antagonist and dexamethasone showed a significant difference in response rate of chemotherapy-induced nausea and vomiting in the first cycle, suggesting that aprepitant would be necessary as a standard antiemetic agent from the first cycle of moderately emetogenic chemotherapy in colon cancer patients.

Keywords

• colonic neoplasms
• nausea
• vomiting
• aprepitant