Combination of palonosetron, aprepitant, and dexamethasone as primary antiemetic prophylaxis for cisplatin-based chemotherapy

Biomed J. 2016 Feb;39(1):60-6. doi: 10.1016/j.bj.2015.08.006. Epub 2016 Mar 29.

Abstract

Background: The purpose of this study was to evaluate the efficacy of combined treatment with the long-acting 5-hydroxytryptamine receptor-3 antagonist, palonosetron, the neurokinin-1 receptor antagonist, oral aprepitant, and dexamethasone as primary antiemetic prophylaxis for cancer patients receiving highly emetogenic cisplatin-based chemotherapy.

Methods: Chemotherapy-naïve patients received the triple combination of palonosetron (0.25 mg), aprepitant (125 mg on day 1 and 80 mg on days 2 and 3), and dexamethasone (20 mg) from the beginning of highly emetogenic chemotherapy with cisplatin-based (≥50 mg/m(2)) regimens. The primary endpoint was a complete response (no emetic episodes and no rescue antiemetics) during the days 1-6.

Results: Sixty-nine hospitalized patients receiving chemotherapy from September 2012 to October 2014 were analyzed. Complete response of vomiting and nausea-free was achieved in 97.1% and 85.5% of patients in the first cycle, respectively, and 96.7% and 83.6% of patients in the second cycle, respectively. Common adverse events in all 69 patients included constipation (43%), hiccup (26%), and headache (4%).

Conclusion: The combination of palonosetron, aprepitant, and dexamethasone as primary antiemetic prophylaxis for cancer patients with highly emetogenic cisplatin-based chemotherapy is effective.

Keywords: Anti-emesis; Aprepitant; Chemotherapy; Cisplatin; Palonosetron.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antiemetics / administration & dosage
  • Antiemetics / therapeutic use*
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Aprepitant
  • Cisplatin / adverse effects*
  • Cisplatin / therapeutic use
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use*
  • Drug Therapy, Combination / methods
  • Female
  • Humans
  • Isoquinolines / administration & dosage
  • Isoquinolines / therapeutic use*
  • Male
  • Middle Aged
  • Morpholines / administration & dosage
  • Morpholines / therapeutic use*
  • Nausea / prevention & control
  • Neoplasms / drug therapy*
  • Palonosetron
  • Quinuclidines / administration & dosage
  • Quinuclidines / therapeutic use*
  • Treatment Outcome
  • Vomiting / prevention & control

Substances

  • Antiemetics
  • Antineoplastic Agents
  • Isoquinolines
  • Morpholines
  • Quinuclidines
  • Aprepitant
  • Palonosetron
  • Dexamethasone
  • Cisplatin