Efficacy of the oral neurokinin-1 receptor antagonist aprepitant for nausea and vomiting induced by cisplatin and carboplatin in Japanese patients with gynecological cancer
Efficacy of the oral neurokinin-1 receptor antagonist aprepitant for nausea and vomiting induced by cisplatin and carboplatin in Japanese patients with gynecological cancer
复制标题
口服神经激肽1受体拮抗剂阿瑞吡坦治疗日本妇科癌症患者顺铂和卡铂所致恶心呕吐的疗效
DOI：
10.1111/jog.13415
复制
发表时间：
2017
影响因子：
1.6
通讯作者：
Mikami Mikio
中科院分区：
文献类型：
--
作者：
Ikeda Masae;Shida Masako;Hirasawa Takeshi;Muramatsu Toshinari;Mikami Mikio
目的本研究旨在评价口服神经激肽-1（NK-1）受体拮抗剂阿瑞匹坦治疗日本妇科癌症患者化疗诱导的恶心/呕吐（CINV）的疗效和效果差异，这些患者接受了高致吐性化疗。（顺铂）和中度致吐方法在日本≥ 2级的患者化疗第二个疗程时加用阿瑞匹坦（不良事件通用术语标准，第3.0版）尽管接受止吐治疗（第一代5-羟色胺3受体拮抗剂+地塞米松），但在第一个疗程期间发生恶心和呕吐，以及尽管仅发生1级恶心和呕吐但要求更强止吐治疗的患者中发生恶心和呕吐。恶心和呕吐的发生率进行了比较，第一和第二个疗程在each group.Results90 - 6（55.5%）的173例患者接受了添加阿瑞匹坦治疗。在接受阿瑞匹坦治疗的患者中，完全缓解（CR：无呕吐或挽救治疗）率显著增加，延迟性CINV的显著改善得到证实。分层分析显示，延迟CINV患者接受卡铂治疗的CR率显著较高，而急性和延迟CINV患者接受顺铂治疗的CR率显著较高。在日本妇科癌症患者中，口服NK-1受体拮抗剂阿瑞匹坦对急性和迟发性CINV联合顺铂治疗和迟发性CINV联合卡铂治疗均有效。
AimThis study was conducted to evaluate the efficacy and the difference in effects of the oral neurokinin‐1(NK‐1) receptor antagonist aprepitant for chemotherapy‐induced nausea/vomiting (CINV) in Japanese patients with gynecological cancer receiving highly emetogenic (cisplatin) and moderately emetogenic (carboplatin) chemotherapy.MethodsAprepitant was added during the second course of chemotherapy in Japanese patients with grade ≥ 2 (Common Terminology Criteria for Adverse Events, version 3.0) nausea and vomiting during the first course despite receiving antiemetic therapy (a first‐generation 5‐hydroxytryptamine 3 receptor antagonist + dexamethasone), and in patients who requested stronger antiemetic therapy despite only having grade 1 nausea and vomiting. The incidence of nausea and vomiting was compared between the first and second courses in each group.ResultsNinety‐six (55.5%) out of 173 patients received add‐on therapy with aprepitant. There was a significant increase in the complete response (CR: no vomiting or salvage therapy) rate in the patients receiving aprepitant, with marked improvement being confirmed for delayed CINV. Stratified analysis showed that patients with delayed CINV treated with carboplatin had a significantly higher CR rate, while patients with both acute and delayed CINV treated with cisplatin had significantly higher CR rates. There was a positive correlation between the incidence of nausea and the incidence of vomiting in the patients treated with aprepitant.ConclusionThe oral NK‐1 receptor antagonist aprepitant could be effective for both acute and delayed CINV with cisplatin and for delayed CINV with carboplatin in Japanese gynecological cancer patients.