Aprepitant Plus Standard Antiemetic Regimen Prevents CINV With FOLFOX for CRC

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Commonly reported adverse events among patients were neutropenia, fatigue, and diarrhea.
Commonly reported adverse events among patients were neutropenia, fatigue, and diarrhea.

Aprepitant plus standard antiemetic prophylactic treatment improved chemotherapy-induced nausea/vomiting (CINV) prevention in patients with colorectal cancer (CRC) treated with fluorouracil, oxaliplatin, and leucovorin (FOLFOX), a study in Supportive Care in Cancer has shown. 

CINV is a commonly occurring adverse event even with prophylactic treatment among patients who receive chemotherapy, and is a significant contributor to patient morbidity and decreased quality of life.

For this study, researchers evaluated the outcomes of 50 patients with CRC treated with FOLFOX who were administered aprepitant 125 mg in addition to palonosetron and dexamethasone. Patient assessments were performed at baseline prior to initiating chemotherapy and daily until 120 hours post chemotherapy. Patients also recorded any information pertaining to treatment such as emesis, rescue doses, appetite, and nutritional intake in a patient diary and returned them to investigators at the start of each cycle.

At completion of the first cycle, 74%, 22%, and 4% of patients reported achieving complete response, major response, and treatment failure, respectively. Patients reported achieving CINV control in subsequent cycles of chemotherapy as well, with 83% of patients maintaining complete response (CR) in cycles 2 and 3, and 86% of patients maintaining CR in cycle 4. Nutritional intake and appetite remained consistent throughout the study.

The most frequently reported adverse events among patients included neutropenia, fatigue, and diarrhea.

Results of the study demonstrated that CINV prevention is attainable with the addition of aprepitant, and the researchers concluded a “larger, randomized, phase III study should be considered in the future to determine the role of aprepitant as primary prophylaxis against CINV with FOLFOX therapy.”

Reference

Bubalo JS, Herrington JD, Takemoto M, et al. Phase II open label pilot trial of aprepitant and palonosetron for the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately emetogenic FOLFOX chemotherapy for the treatment of colorectal cancer [published online October 31, 2017]. Support Care Cancer. doi: 10.1007/s00520-017-3950-y

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