A study on the efficacy and safety of aprepitant injection in preventing and treating nausea and vomiting induced by platinum-based chemotherapy in lung cancer

Abstract

This study aimed to assess the clinical efficacy and safety of aprepitant injection in preventing and treating nausea and vomiting induced by platinum-based chemotherapy in lung cancer patients. Forty-eight patients with advanced first-line lung cancer undergoing cisplatin- or carboplatin-based chemotherapy were randomly assigned to either the experimental group or the control group, with 24 patients in each group. The control group received dexamethasone and palonosetron for vomiting prevention, whereas the experimental group received dexamethasone, palonosetron, and aprepitant injection. The study compared the incidence of acute and delayed vomiting, functional life index (FLIE) scores for nausea and vomiting at 24 and 120 h postchemotherapy and the occurrence of adverse drug reactions between the two groups. The effective control rate of acute-phase vomiting in the treatment group was 83.33%, significantly higher than 45.83% in the control group, with a statistically significant difference (p < .05). The treatment group also demonstrated a higher effective control rate of delayed vomiting, with 75% compared with 41.67% in the control group, which was statistically significant (p < .05). Furthermore, FLIE scores in the treatment group at 24 and 120 h after chemotherapy were higher compared with the control group, with a statistically significant difference (p < .05). The incidence of complications such as fatigue, headache, dyspepsia, anorexia, hiccup, and constipation showed no significant difference between the two groups (p > .05). Aprepitant injection effectively prevents platinum-based chemotherapy-induced nausea and vomiting, enhances patients' quality of life, and demonstrates good safety, justifying its clinical adoption.

Keywords

aprepitant injection / lung cancer / prophylactic antiemetic

References

[1] Yang D, Liu Y, Bai C, et al. Epidemiology of lung cancer and lung cancer screening programs in China and the United States. Cancer Lett. 2020;1(468):82-87.

[2] Kinomura M, Iihara H, Fujii H, et al. Effect of mirtazapine for the prevention of nausea and vomiting in patients with thoracic cancer receiving platinum-based chemotherapy. Anticancer Res. 2023;43(3):1301-1307.

[3] Shimokawa M, Haratake N, Takada K, et al. Combination antiemetic therapy for chemotherapy-induced nausea and vomiting in patients with NSCLC receiving carboplatin-based chemotherapy. Cancer Manag Res. 2022;9(14):2673-2680.

[4] Cancer Rehabilitation and Palliative Care Professional Committee of Shanghai Anti Cancer Association. Shanghai expert consensus on the whole course management of chemotherapy induced nausea and vomiting (2018 edition). Chin Oncol. 2018;28(12):946-960.

[5] Lyons E, Line C, Lee JJ. Developing drugs for prevention of chemotherapy-induced nausea and vomiting: draft guidance from the FDA. Clin Cancer Res. 2021;27(22):6072-6074.

[6] Frazier R, Li BUK, Venkatesan T. Diagnosis and management of cyclic vomiting syndrome: a critical review. Am J Gastroenterol. 2023;118:1157-1167.

[7] AlAlikhan A, Ghahremanloo A, Javid H, Ebrahimi S, Hashemy SI. The effect of blocking neurokinin-1 receptor by aprepitant on the inflammatory and apoptosis pathways in human ovarian cancer cells. Cell Biochem Biophys. 2022;80(4):819-827.

[8] Schwartzberg LS, Navari RM. Safety of polysorbate 80 in the oncology setting. Adv Ther. 2018;35(6):754-767.

[9] Navari RM. Safety profile of HTX-019 administered as an intravenous push in cancer patients: a retrospective review. Expert Opin Drug Saf. 2020;19(2):205-210.

[10] Perry TS, Dickson N, Patton JF. Safety of antiemetic prophylaxis with HTX-019 as a 30-min infusion in patients with cancer: a retrospective study. Future Oncol. 2020;16(7):263-268.

[11] Wan BA, Drost L, Ganesh V, et al. Evaluation of the 3-day recall period for the functional life index-emesis (FLIE). Ann Palliat Med. 2018;7(4):393-403.

[12] Araújo A, Tavares N, Faria AL, et al. Evaluation of current antiemetic therapy response in patients undergoing MEC or HEC regimens in Portugal. Curr Oncol. 2023;30(2):1529-1537.

[13] Navari RM. The safety of rolapitant for the treatment of nausea and vomiting associated with chemotherapy. Expert Opin Drug Saf. 2019;18(12):1127-1132.

[14] Thom C, Ehrenmann J, Vacca S, et al. Structures of neurokinin 1 receptor in complex with G_q and G_s proteins reveal substance P binding mode and unique activation features. Sci Adv. 2021;7(50):eabk2872.

[15] Tyler T, Schultz A, Venturini A, et al. Challenges in the development of intravenous neurokinin-1 receptor antagonists: results of a safety and pharmacokinetics dose-finding, phase 1 study of intravenous fosnetupitant. Clin Pharmacol Drug Dev. 2022;11(12):1405-1418.

[16] Dranitsaris G, Moezi M, Dobson K, Phelan R, Blau S. A real-world study to evaluate the safety and efficacy of three injectable neurokinin-1 receptor antagonist formulations for the prevention of chemotherapy-induced nausea and vomiting in cancer patients. Support Care Cancer. 2022;30(8):6649-6658.

[17] Wenqi J, Yi B, Jifeng F, et al. Consensus of Chinese experts on the prevention and treatment of nausea and vomiting related to tumor drug therapy (2019 edition). Chin J Front Med Sci (Electron ed). 2019;11(11):16-26.

[18] Hesketh PJ, Kris MG, Basch E, et al. Antiemetics: ASCO Guideline update. J Clin Oncol. 2020;38(24):2782-2797.

[19] Patel P, Robinson PD, Cohen M, et al. Prevention of acute and delayed chemotherapy-induced nausea and vomiting in pediatric cancer patients: a clinical practice guideline. Pediatr Blood Cancer. 2022;69(12):e30001.

RIGHTS & PERMISSIONS

2024 2024 The Authors. Precision Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Nanjing Medical University Affiliated Cancer Hospital & Jiangsu Cancer Hospital.