Abstract Children aged 2-12 years scheduled to receive moderately or
highly emetogenic chemotherapy were randomly assigned to arm-A
(fosaprepitant) or arm-B (aprepitant). Children recruited to arm-A
received intravenous ondansetron plus dexamethasone followed by
fosaprepitant infusion. Children recruited to arm-B received the same
drugs as those given to children in arm-A, except that fosaprepitant was
substituted with aprepitant. The primary end point of the study was to
determine the proportion of patients who achieved a CR, defined as no
vomiting, no retching, and no use of rescue medication, the proportion
of patients who achieved a CR during the acute phase (0-24 hours) after
administration of the last dose of chemotherapy. Secondary end points
were the proportion of patients who achieved a CR during the 24-120
hours (delayed phase) and overall after administration of the last dose
of chemotherapy. Results: One hundred and eight patients were analyzed
(55 in the fosaprepitant arm and 53 in the aprepitant arm). CR rates
were higher in the fosaprepitant arm compared with the aprepitant arm
during the acute phase (95 % vs 79 %, P =0.01< 0.05),
delayed phase (71 % vs 66 %, P =0.89 ), and overall phase (69 % vs 57
%, P =0.18). Furthermore, the demand of rescue anti-emetics observed in
fosaprepitant arm (7 %) has no difference with aprepitant arm (11 %).
Conclusion: Addition of fosaprepitant to ondansetron and dexamethasone
is more effective than aprepitant for the prevention of acute vomiting.
Comparative study of fosaprepitant and aprepitant for the prevention of chemotherapy-induced nausea and vomiting in pediatric cancer patients
