Aprepitant and Fosaprepitant: A 10-Year Review of Efficacy and Safety
Aprepitant and Fosaprepitant: A 10-Year Review of Efficacy and Safety
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DOI：
10.1634/theoncologist.2014-0229
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发表时间：
2015-04-01
期刊：
影响因子：
5.8
通讯作者：
Warr, David
中科院分区：
文献类型：
--
作者：
Aapro, Matti;Carides, Alexandra;Warr, David
化疗引起的恶心和呕吐（CINV）是与抗癌治疗相关的常见不良事件，可对患者健康相关的生活质量产生重大不利影响，并可能破坏化疗的有效性。预防CINV的传统方案通常包括皮质类固醇加5-羟色胺（SHT3）受体拮抗剂（RA）的联合治疗。在过去的10年里，随着神经激肽-1受体拮抗剂（NK1 RA）阿瑞吡坦及其前药fosaprepitant的出现，止吐治疗取得了很大的进展。NK1 RAs在CINV中的作用机制与皮质类固醇和SHT3 RAs不同，因此它们的使用可以补充传统的止吐药物，并可以加强对CINV的控制。本综述审查了阿瑞吡坦和fosaprepitant自首次获得监管批准以来的十年中积累的有关其安全性和有效性的数据。从阿瑞吡坦和磷沙吡坦预防中度和高度致吐性化疗患者CINV的关键研究数据进行了探讨，以及目前可用的指南中对其使用的建议。此外，还强调了它们在特殊患者群体中的止吐作用。提出了阿瑞吡坦和磷酸沙吡坦用于CINV以外适应症的未来前景。
Chemotherapy-induced nausea and vomiting (CINV) is a common adverse event associated with anticancer treatment that can have a significant adverse impact on patient health-related quality of life and that can potentially undermine the effectiveness of chemotherapy. Traditional regimens to prevent CINV generally involved a combination of a corticosteroid plus a 5-hydroxytryptamine (SHT3) receptor antagonist (RA). In the past 10 years, antiemetic treatment has greatly advanced with the availability of the neurokinin-1 receptor antagonist (NK1 RA) aprepitant and its prodrug fosaprepitant. NK1 RAs have a different mechanism of action in CINV than corticosteroids and SHT3 RAs, thus their use can complement traditional antiemetic drugs and can enhance control of CINV. This review examined accumulated data regarding the safety and efficacy of aprepitant and fosaprepitant over the decade since the first regulatory approval. Data from key studies of aprepitant and fosaprepitant in the prevention of CINV in patients receiving moderately and highly emetogenic chemotherapy were explored, as were recommendations in currently available guidelines for their use. In addition, their use as antiemetic therapy in special patient populations was highlighted. Future perspectives on potential uses of aprepitant and fosaprepitant for indications other than CINV are presented.