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Hatsuyama T.,Hokkaido Keiaikai Sapporo Minami Sanjo Hospital | Umehara K.,Hokkaido Keiaikai Sapporo Minami Sanjo Hospital | Wakamoto A.,Hokkaido Keiaikai Sapporo Minami Sanjo Hospital | Sato H.,Hokkaido Pharmaceutical University School of Pharmacy
Japanese Journal of Cancer and Chemotherapy | Year: 2015

Guidelines for antiemetic therapy, such as the American Society of Clinical Oncology (ASCO) guidelines, recommend that aprepitant, an NK1 receptor antagonist, should be used in addition to conventional antiemetic therapy for acute and delayed nausea/vomiting caused by highly emetogenic chemotherapy. However, only few studies have been conducted to evaluate the efficacy of aprepitant in patients receiving moderately emetogenic chemotherapy. Therefore, we examined the antiemetic effects of additional doses of aprepitant in the next course in patients with lung cancer who were undergoing chemotherapy with carboplatin and who developed chemotherapy-induced nausea and vomiting (CINV) despite the preventive administration of a 5-HT3 receptor antagonist and dexamethasone. Consequently, the incidences of vomiting and nausea significantly decreased from 59% to 0% and from 91% to 64%, respectively, during the entire study period. Furthermore, a significant improvement in dietary intake during the entire study period was confirmed. These results suggest that the additional administration of aprepitant has high antiemetic effects in patients with lung cancer who are undergoing chemotherapy with carboplatin and who show insufficient control of nausea/vomiting. Source


Sato H.,Hokkaido Keiaikai Sapporo Minami Sanjo Hospital | Wada K.,Hokkaido Keiaikai Sapporo Minami Sanjo Hospital | Umehara K.,Hokkaido Keiaikai Sapporo Minami Sanjo Hospital | Otsu K.,Hokkaido Keiaikai Sapporo Minami Sanjo Hospital | And 4 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2013

Aprepitant is a NK1 receptor-antagonist with a novel mechanism of action for chemotherapy-induced nausea and vomiting (CINV), and is recommended as a prophylactic by many international and domestic guidelines. However, domestic clinical trials of aprepitant have only been conducted using a single dose in patients who were treated with cisplatin (CDDP), and there is no evidence to support administration of aprepitant in divided doses. We administered aprepitant in divided doses to patients who were also being treated with cisplatin, ifosfamide, and irinotecan (CIC), and had CINV due to prophylactic administration of a 5-HT3 receptor antagonist and dexamethasone. This was done in order to evaluate the antiemetic effect of aprepitant. The patients with "No vomiting" increased significantly from 25% to 83%, and the "Days with nausea" in patients also decreased significantly. Consequently, administration of aprepitant in addition to current antiemetic therapy in divided doses, as well as in single doses, exhibited a greater antiemetic effect in CDDP-treated patients. Source

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