A randomised, placebo-controlled, double-blind study of aprepitant in nondrinking women younger than 70 years receiving moderately emetogenic chemotherapy

作者：Tanioka M^*; Kitao A; Matsumoto K; Shibata N; Yamaguchi S; Fujiwara K; Minami H; Katakami N; Morita S; Negoro S

来源：British Journal of Cancer, 2013, 109(4): 859-865.

DOI：10.1038/bjc.2013.400

• aprepitant
• moderately emetogenic chemotherapy
• carboplatin
• female
• alcohol use

Background: We evaluated the efficacy of aprepitant plus granisetron and an increased dose of dexamethasone in selected patients undergoing moderately emetogenic chemotherapy (MEC). %26lt;br%26gt;Methods: Nondrinking women %26lt;70 years undergoing MEC were randomly assigned to aprepitant (day 1, 125 mg; days 2 and 3, 80 mg) or placebo. Dexamethasone on days 1-3 was 12, 4, and 4mg with aprepitant and 20, 8, and 8mg with placebo. The primary end point was complete response (CR; no emesis or rescue therapy) during 120 h of the first cycle. Logistic regression analysis was performed to identify predictors of overall CR. %26lt;br%26gt;Results: Of the 94 patients enrolled, 91 were assessable. Most received carboplatin-based chemotherapy. In the aprepitant (n = 45) and placebo (n = 46) groups, the overall, acute (day 1), and delayed (days 2-5) CR rates were 62% and 52%, 98% and 96%, and 62% and 52%, respectively. Although not statistically significant, the overall CR rate was 10% higher in the aprepitant group. Both regimens were well tolerated. On multivariate analysis, advanced ovarian cancer (OR, 0.26 (0.10-0.72)) was independently associated with a lower CR. %26lt;br%26gt;Conclusion: Even with an increased dose of dexamethasone, aprepitant seemed more effective than placebo in these selected patients undergoing MEC; however, delayed phase management remains a significant problem.

• 出版日期2013-8-20