Antiemetic therapy of fosaprepitant, palonosetron, and dexamethasone combined with cisplatin-based chemotherapy for head and neck carcinomas

Acta Otolaryngol. 2014 Nov;134(11):1198-204. doi: 10.3109/00016489.2014.913314.

Abstract

Conclusion: Concomitant antiemetic therapy comprising fosaprepitant, palonosetron, and dexamethasone is effective for head and neck carcinoma.

Objective: A patient diary was constructed to determine the effectiveness of concomitant antiemetic therapy with a neurokinin-1 receptor antagonist (fosaprepitant), 5-hydroxytryptamine receptor antagonist (palonosetron), and dexamethasone in accordance with guidelines.

Methods: Subjects comprised 41 patients who received 71 courses of chemotherapy, along with fosaprepitant, palonosetron, and dexamethasone. A patient diary was compiled concerning the presence/absence of vomiting, vomiting episodes, presence/absence of rescue therapy, food intake, presence/absence of nausea, and general condition.

Results: The frequency of the primary end point of complete response in the overall phase was 69.0%. The proportion of patients with no vomiting in the overall phase was 90.1%. In the acute phase, the proportion of no nausea and slight nausea together was 91.5%, no change in and slightly reduced food intake together was 87.3%, and the proportion of good general condition and relatively good general condition was 85.9%. In the delayed phase, the proportion of no nausea and slight nausea together was 56.3%, no change in and slightly reduced food intake together was 43.7%, and the proportion of good general condition and relatively good general condition together was 53.5%.

Keywords: CINV; Chemotherapy-induced nausea and vomiting; aprepitant; food intake; rescue therapy.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Antiemetics / therapeutic use*
  • Antineoplastic Agents / adverse effects*
  • Carcinoma / drug therapy*
  • Cisplatin / adverse effects*
  • Dexamethasone / therapeutic use
  • Drug Therapy, Combination
  • Eating / drug effects
  • Female
  • Head and Neck Neoplasms / drug therapy*
  • Humans
  • Isoquinolines / pharmacology
  • Isoquinolines / therapeutic use
  • Male
  • Middle Aged
  • Morpholines / pharmacology
  • Morpholines / therapeutic use
  • Nausea / chemically induced
  • Nausea / prevention & control*
  • Neurokinin-1 Receptor Antagonists / therapeutic use
  • Palonosetron
  • Quinuclidines / pharmacology
  • Quinuclidines / therapeutic use
  • Serotonin Antagonists / therapeutic use

Substances

  • Antiemetics
  • Antineoplastic Agents
  • Isoquinolines
  • Morpholines
  • Neurokinin-1 Receptor Antagonists
  • Quinuclidines
  • Serotonin Antagonists
  • Palonosetron
  • fosaprepitant
  • Dexamethasone
  • Cisplatin