Abstract:

Objective To observe the clinical efficacy and adverse reactions of aprepitant in the prevention of nausea and vomiting induced by cisplatin chemotherapy. Methods One hundred and eight patients with lung cancer receiving cisplatin（25 mg/m2， d1-d3）-containing chemotherapy regimens in Zhejiang Cancer Hospital from August 1， 2014 to June 20， 2015 were enrolled. The antiemetic regiem for aprepitant group consisted of aprepitant（125 mg po d1，80 mg po d2-d3）， tropisetron（5 mg iv d1-d6）and dexamethasone（12 mg po d1，8 mg po d2-d4）. The regimen for control group was tropisetron（5 mg iv d1-d6） and dexamethasone（12 mg po d1，8 mg po d2-d4）. The primary endpoints were the percentage of patients with a complete remission（no nausea and no salvage treatment） during the acute phase（0-24 h） and the delayed phase（24-120 h）. The secondary endpoint was the percentage of patients with severe nausea during the entire study period（0-120 h）. Common Terminology Criteria for Adverse Events （CTCAE）4.0 was adopted for classification for adverse reactions. The functional living index-emesis （FLIE）was adopted to assess patients’ quality of life. Results The complete remission rates of vomiting for acute period in aprepitant group and control group were 90.7% and 75.9%（P=0.039）， respectively. The complete remission rates of vomiting for delayed period in aprepitant group and control group were 81.5% and 61.1%（P=0.019）， respectively. The aprepitant group’s vomiting preventive effect was better than the control group. The percentage of patients with severe nausea during the entire study period in aprepitant group and control group were 18.5% and 37.0%（P=0.032）， respectively. The FLIE score of aprepitant group and control group were 111.67±17.02 and 104.89±17.32（P=0.047）， respectively. The percentages of constipation and singultation of aprepitant group were higher than those of control group. Conclusion The aprepitant is effective for nausea and vomiting induced by cisplatin-containing chemotherapy. Further clinical study is warranted to assess the adverse reactions.