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The efficacy of aprepitant in salvage treatment of chemotherapy-induced nausea and vomiting associated with moderately emetogenic chemotherapy for patients with gastrointestinal cancer

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Abstract

Purpose

To evaluate the efficacy of aprepitant and its effect on the quality of life when added to standard antiemetic therapy as salvage therapy.

Patients and methods

This is an open-label, noncomparative prospective phase II clinical trial. A total of 224 patients receiving initial moderately emetogenic chemotherapy (MEC) were enrolled. Patients received standard antiemetic treatment (5-hydroxytryptamine (5-HT3) antagonists + dexamethasone) in the first cycle. Patients failing to achieve a complete response (CR) during cycle 1 entered cycle 2 with the addition of aprepitant as salvage treatment.

Results

Of the 224 patients eligible for cycle 1, 159 (71.0%, 95% CI 65.0–77.0) had a CR, and 65 patients with a noncomplete response (NCR) proceeded to cycle 2 to receive aprepitant-based salvage therapy. Then, 49 (75.4%, 95% CI 64.6–84.1) of these patients achieved a CR. The Functional Living Index-Emesis (FLIE) questionnaire showed that NCR patients in cycle 1 had an improved quality of life after receiving aprepitant-based salvage therapy in cycle 2 (cycle 1 and 2: 80.3 vs 114.0, P < 0.001). Failing to achieve a CR had a significant impact on the quality of life in both cycle 1 (FLIE score of NCR and CR patients: 80.3 vs 119.7, P < 0.001) and cycle 2 (FLIE score of NCR and CR patients: 88.3 vs 122.4, P < 0.001).

Conclusion

The addition of aprepitant as salvage therapy for patients with gastrointestinal cancer is effective and has a positive effect on quality of life.

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Acknowledgements

This study was supported by the Chinese Society of Clinical Oncology. We thank Miss Yan Zhou for assistance in data collection.

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Authors and Affiliations

  1. Department of Clinical Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan, China

    Qiaoyan Gong & Lingyan Zhou

  2. Department of Abdominal Oncology, Cancer Center of West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    **aofen Li & Dan Cao

  3. Department of Oncology, China National Nuclear Corporation 416 Hospital, Chengdu, Sichuan, China

    Jiangfang Tian

  4. Chinese Journal of Obstetrics and Gynecology and Pediatrics (Electronic Edition), West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

    Yulian Jiang

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  1. Qiaoyan Gong
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  4. **aofen Li
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Correspondence to Dan Cao.

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The authors declare that they have no conflicts of interest associated with this work. We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.

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Gong, Q., Tian, J., Jiang, Y. et al. The efficacy of aprepitant in salvage treatment of chemotherapy-induced nausea and vomiting associated with moderately emetogenic chemotherapy for patients with gastrointestinal cancer. Int J Clin Oncol 26, 1091–1098 (2021). https://doi.org/10.1007/s10147-021-01898-9

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  • DOI: https://doi.org/10.1007/s10147-021-01898-9

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