scholarly journals Effectiveness of antiemetics in control of antineoplastic chemotherapy-induced emesis at home

2014 ◽  
Vol 27 (5) ◽  
pp. 412-418 ◽  
Author(s):  
Marielly Cunha Castro ◽  
Suely Amorim de Araújo ◽  
Thaís Rezende Mendes ◽  
Glauciane Silva Vilarinho ◽  
Maria Angélica Oliveira Mendonça

Objective Evaluating if antiemetics are effective in the prevention or treatment at home, of chemotherapy-induced emesis. Methods In total, were included 42 women with breast cancer in moderately emetogenic chemotherapy, using dexamethasone/ondansetron before each cycle. The frequency of nausea and vomiting was obtained by applying the instrument in the pre-chemotherapy period, and 24h, 48h, 72h and 96h after chemotherapy. The use of antiemetics was considered in accordance with adherence to medical prescription. Results All patients (n = 42, 100%) reported emesis at some point. Only five cases (11.9%) were anticipatory. In the first 24 hours (acute emesis), 38 (90.5%)ayed), emesis was reported by all despite the regular use (n = 20, 47.6%) or not (n = 22, 52.4%) of antiemetics (ondansetron, dexamethasone and metoclopramide/or dimenhydrinate). Conclusion Antiemetics were not effective in the prevention or treatment at home, of chemotherapy-induced emesis.

2016 ◽  
Vol 4 (1) ◽  
pp. 20-25
Author(s):  
Bruno Vincenzi ◽  
Anna Maria Frezza ◽  
Marianna Silletta ◽  
Emanuela Dell’Aquila ◽  
Giovanna Catania ◽  
...  

Background Despite the efficacy of prophylaxis with serotonin type 3 (5-HT3) receptor antagonists, nausea and vomiting are still among the most common chemotherapy-induced toxicities. The aim of this study was to evaluate the efficacy of adding aprepitant in patients with chemotherapy-induced nausea and vomiting (CINV) refractory to prophylaxis with 5-HT3 receptor antagonists and dexamethasone. Patients and Methods Between January 2008 and November 2010, 51 patients (median age 59 years) with a variety of malignancies (breast cancer: 23; lung cancer: 12; sarcoma: 6; ovarian cancer: 3; other: 7) were enrolled. All patients were refractory to antiemetic therapy according to ASCO guidelines and developed at least grade 2 nausea and/or vomiting after the first chemotherapy course. Aprepitant was given at 125 mg on day 1 and 80 mg on days 2–3. Patients also received a single dose of palonosetron 250 μg on day 1 plus dexamethasone 12–20 mg at a constant dose. Results After addition of aprepitant, the number of patients with grade 3/4 nausea decreased from 31 (61%) to 4 (8%), and those with grade 2 nausea from 20 (39%) to 6 (12%) [both p


2005 ◽  
Vol 23 (12) ◽  
pp. 2822-2830 ◽  
Author(s):  
David G. Warr ◽  
Paul J. Hesketh ◽  
Richard J. Gralla ◽  
Hyman B. Muss ◽  
Jørn Herrstedt ◽  
...  

Purpose This is the first study in which the NK1-receptor antagonist, aprepitant (APR), was evaluated for the prevention of chemotherapy-induced nausea and vomiting (CINV) with moderately emetogenic chemotherapy. Patients and Methods Eligible breast cancer patients were naive to emetogenic chemotherapy and treated with cyclophosphamide ± doxorubicin or epirubicin. Patients were randomly assigned to either an aprepitant regimen (day 1, APR 125 mg, ondansetron (OND) 8 mg, and dexamethasone 12 mg before chemotherapy and OND 8 mg 8 hours later; days 2 through 3, APR 80 qd) or a control regimen (day 1, OND 8 mg and dexamethasone 20 mg before chemotherapy and OND 8 mg 8 hours later; days 2 through 3, OND 8 mg bid). Data on nausea, vomiting, and use of rescue medication were collected with a self-report diary. The primary efficacy end point was the proportion of patients with complete response, defined as no vomiting and no use of rescue therapy, during 120 hours after initiation of chemotherapy in cycle 1. The secondary end point was the proportion of patients with an average item score higher than 6 of 7 on the Functional Living Index–Emesis questionnaire. Results Of 866 patients randomized, 857 patients (99%) were assessable. Overall complete response was greater with the aprepitant regimen than with the control regimen (50.8% v 42.5%; P = .015). More patients in the aprepitant group reported minimal or no impact of CINV on daily life (63.5% v 55.6%; P = .019). Both treatments were generally well tolerated. Conclusion The aprepitant regimen was more effective than the control regimen for prevention of CINV in patients receiving both an anthracycline and cyclophosphamide.


1998 ◽  
Vol 6 (4) ◽  
pp. 389-395 ◽  
Author(s):  
J. J. Rusthoven ◽  
David Osoba ◽  
Charles A. Butts ◽  
Louise Yelle ◽  
Helen Findlay ◽  
...  

2004 ◽  
Vol 12 (3) ◽  
pp. 173-176
Author(s):  
Fausto Roila

Important progress has been achieved in the last few years in the prevention of chemotherapy-induced nausea and vomiting thanks to the introduction in clinical practice first of the 5-HT3 antagonists and of the NK1 antagonists more recently. To prevent acute emesis induced by cisplatin, moderately emetogenic chemotherapy, a combination of aprepitant plus a 5-HT3 antagonist and dexamethasone is now the most efficacious regimen. For the prevention of delayed emesis induced by cisplatin, moderately emetogenic chemotherapy, a combination of dexamethasone plus aprepitant or metoclopramide or a 5- HT3 antagonist / dexamethasone or a 5-HT3 antagonist are the preferred antiemetic regimens. For the prevention of acute emesis induced by low emetogenic chemotherapy a prophylaxis with a single antiemetic drug such as dexamethasone is suggested while no antiemetic prophylaxis should be administered to prevent acute emesis induced by minimal emetogenic chemotherapy or to prevent delayed emesis induced by low or minimal emetogenic chemotherapy. In this last case a rescue therapy should be administered in patients presenting acute or delayed emesis.


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