Adding Aprepitant Not Beneficial for Carboplatin-Induced CINV Prevention in NSCLC

Adding aprepitant to palonosetron and dexamethasone provided no improvement in carboplatin-induced emesis in non-small cell lung cancer.
Adding aprepitant to palonosetron and dexamethasone provided no improvement in carboplatin-induced emesis in non-small cell lung cancer.

Adding aprepitant to palonosetron and dexamethasone provided no improvement in carboplatin-induced emesis in patients with advanced non-small cell lung cancer (NSCLC), a new study published online ahead of print in the journal Lung Cancer has shown.1

The benefit of combination antiemetic therapy with dexamethasone and palonosetron compared with other 5-HT3 receptor antagonists in carboplatin-based chemotherapy is unclear. Because the effectiveness of adding aprepitant for the prevention of chemotherapy-induced nausea and vomiting (CINV) in moderately emetogenic chemotherapy is unknown as well, researchers sought to compare the efficacy and safety of triple vs double antiemetic therapy in patients with advanced NSCLC receiving carboplatin-based chemotherapy.

For the prospective, controlled study, researchers enrolled 80 chemotherapy-naïve patients with advanced NSCLC and randomly assigned them to receive double antiemetic therapy with palonosetron plus dexamethasone or triple antiemetic therapy with the same combination plus aprepitant.

Results showed that the overall complete response rate was 80.5% (95% CI, 68.4 – 92.6) with triple antiemetic therapy and 76.9% (95% CI, 63.7 – 90.1) with double therapy (OR, 0.81; 95% CI, 0.27 – 2.36; P=.788).

There were also no significant differences in complete responses during the acute or delayed phases and overall incidences of treatment-related side effects were similar between both treatment arms.

“According to the selection design, triple antiemetic therapy with aprepitant, palonosetron, and dexamethasone was not considered as an option for further studies,” the authors conclude.

REFERENCE

1. Kusagaya H, Inui N, Karayama M, et al. Evaluation of palonosetron and dexamethasone with or without aprepitant to prevent carboplatin-induced nausea and vomiting in patients with advanced non-small-cell lung cancer [published online ahead of print November 7, 2015]. Lung Cancer. doi:10.1016/j.lungcan.2015.11.009.

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