Single-dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients receiving moderately emetogenic chemotherapy regimens: a subgroup analysis from a randomized clinical trial of response in subjects by cancer type

Background: Results from a phase III, randomized, double-blind, active comparator-controlled, parallel-group trial evaluating fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting (CINV) found that a single-day, triple-antiemetic fosaprepitant regimen resulted in a significant...

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Main Authors: Weinstein, Cindy (Author) , Jordan, Karin (Author) , Green, Stuart (Author) , Khanani, Saleem (Author) , Beckford-Brathwaite, Elizabeth (Author) , Vallejos, Waldimir (Author) , Pong, Annpey (Author) , Noga, Stephen J. (Author) , Rapoport, Bernardo L. (Author)
Format: Article (Journal)
Language:English
Published: 25 September 2020
In: BMC cancer
Year: 2020, Volume: 20
ISSN:1471-2407
DOI:10.1186/s12885-020-07259-5
Online Access:Resolving-System, Volltext: https://doi.org/10.1186/s12885-020-07259-5
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Author Notes:Cindy Weinstein, Karin Jordan, Stuart Green, Saleem Khanani, Elizabeth Beckford-Brathwaite, Waldimir Vallejos, Annpey Pong, Stephen J. Noga and Bernardo L. Rapoport

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520 |a Background: Results from a phase III, randomized, double-blind, active comparator-controlled, parallel-group trial evaluating fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting (CINV) found that a single-day, triple-antiemetic fosaprepitant regimen resulted in a significantly higher proportion of patients achieving a complete response (CR; no vomiting or rescue medication use) in the delayed phase (25-120 h after chemotherapy initiation), compared with a 3-day control regimen (ClinicalTrials.gov, NCT01594749). As the risk for CINV is dependent on chemotherapy regimen and generally guided by tumor type, this post hoc analysis evaluated the efficacy and safety of this regimen by cancer subpopulations (gastrointestinal [GI] or colorectal, lung, breast, and gynecologic cancers). Methods: Subjects with confirmed cancer who were naive to highly and moderately emetogenic chemotherapy (HEC and MEC) and were scheduled to receive intravenous (IV) anthracycline-cyclophosphamide (AC)-based MEC on the first day of chemotherapy were randomly assigned to receive oral ondansetron and oral dexamethasone plus either a single IV dose of fosaprepitant 150 mg (fosaprepitant regimen) or placebo (control regimen). The primary efficacy end point was the proportion of subjects achieving CR in the delayed phase. CR rates in the overall and acute phases (0-120 h and 0-24 h after MEC initiation, respectively) were assessed as secondary end points. Safety and tolerability were also assessed. Results CR rates in the delayed phase favored the fosaprepitant regimen over the control regimen across the GI/colorectal, lung, breast, and gynecologic cancer subgroups (range, 6.2-22%); similar findings were observed for CR in the overall phase. CR in the acute phase was high for all groups (>= 87%). The fosaprepitant regimen was well tolerated in all cancer subgroups. Conclusions This post hoc analysis indicated that a single-day fosaprepitant regimen was effective in preventing CINV in patients receiving MEC, regardless of cancer type. 
650 4 |a antiemetics american society 
650 4 |a Breast cancer 
650 4 |a Chemotherapy-induced nausea and vomiting (CINV) 
650 4 |a cinv 
650 4 |a double-blind 
650 4 |a efficacy 
650 4 |a Fosaprepitant 
650 4 |a Gastrointestinal cancer 
650 4 |a guideline 
650 4 |a Gynecologic cancer 
650 4 |a Lung cancer 
650 4 |a oncology 
650 4 |a rolapitant 
650 4 |a update 
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