Aprepitant for Nausea and Vomiting Induced by Highly and Moderately Emetogenic Chemotherapy in Japanese Patients with Gastrointestinal Cancer: A Single-Center, Retrospective Study

It is important to prevent nausea and vomiting to maintain both the quality of life of patients with cancer and the efficacy of chemotherapy. The aim of this study was to examine the efficacy of aprepitant for treatment of chemotherapy-induced nausea and vomiting (CINV) in Japanese patients with gastrointestinal cancer receiving highly or moderately emetogenic chemotherapy (HEC or MEC) regimens. A singlecenter, retrospective study was performed in 37 consecutive patients scheduled for HEC (n=7) or MEC (n=30). The MASCC Antiemesis Tool (MAT) was used to assess CINV and safety and patient charts were assessed before and after use of the aprepitant regimen. During the first course of chemotherapy, patients received a standard antiemetic regimen. Aprepitant was added in the second chemotherapy cycle for patients who had insufficient relief of CINV with the standard antiemetic regimen. All patients in the HEC cohort were treated with S-1 and cisplatin and those in the MEC cohort received chemotherapy including FOLFOX, FOLFIRI and irinotecan monotherapy. In patients receiving HEC, CINV symptoms tended to improve with use of aprepitant compared with antiemetic regimens without aprepitant; however, the differences were not significant. In patients receiving MEC, there were significant differences in acute and delayed nausea and vomiting with aprepitant treatment (p<0.05, Wilcoxon rank test). CINV symptoms improved in 70% and 78% of patients treated with HEC and MEC, respectively. These results suggest that aprepitant is effective for preventing CINV in patients with gastrointestinal cancer receiving HEC or MEC.