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Aprepitant Promotes Caspase-Dependent Apoptotic Cell Death and G2/M Arrest through PI3K/Akt/NF- κB Axis in Cancer Stem-Like Esophageal Squamous Cell Carcinoma Spheres. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8808214. [PMID: 34926694 PMCID: PMC8677400 DOI: 10.1155/2021/8808214] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/05/2021] [Accepted: 11/18/2021] [Indexed: 12/16/2022]
Abstract
The antagonists of the neurokinin-1 receptor (NK1R) are known for their anti-inflammatory, anxiolytic, antiemetic, and anticancer activities. Aprepitant, a nonpeptide NK1R antagonist, is used in nausea and vomiting, the most common side effects of cancer chemotherapy in patients. It has been established that NK1R activation by substance P (SP), which links cancer promotion and progression to a neurokinin-mediated environment, became one mechanism that corresponds to the mitogenesis of tumor cells. Therefore, this study is aimed at explaining and evaluating the anticancer impacts of aprepitant on esophageal squamous cancer cell (ESCC) spheres by using in vitro experiments, such as resazurin, ROS, annexin-V binding, RT-PCR, and Western blot analysis. As a result, we showed that aprepitant had strong antiproliferative and cytotoxic effects on ESCC cell spheres. Also, aprepitant caused significant G2-M cell cycle arrest depending on concentration increase. Further, exposure of cells to this agent resulted in caspase -8/-9-dependent apoptotic pathway activation by modifying the expression of genes involved in apoptosis. Besides, treatment of the cells by aprepitant abrogates of the PI3K/Akt pathway, as shown by reducing the level of Akt, induces apoptotic cell death. In summary, pharmacological inhibition of NK1R with aprepitant seems to have a significant chance of treating ESCC as a single agent or in conjunction with other chemotherapeutic drugs.
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Cabanillas Stanchi KM, Willier S, Vek J, Schlegel P, Queudeville M, Rieflin N, Klaus V, Gansel M, Rupprecht JV, Flaadt T, Binder V, Feuchtinger T, Lang P, Handgretinger R, Döring M. Antiemetic Prophylaxis with Fosaprepitant and 5-HT 3-Receptor Antagonists in Pediatric Patients Undergoing Autologous Hematopoietic Stem Cell Transplantation. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:3915-3927. [PMID: 33061297 PMCID: PMC7524181 DOI: 10.2147/dddt.s260887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/21/2020] [Indexed: 02/03/2023]
Abstract
Background High-dose myeloablative conditioning prior to autologous hematopoietic stem cell transplantation (autoHSCT) in pediatric patients is usually highly emetogenic. The antiemetic neurokinin-1 receptor antagonist fosaprepitant was safe and effective in children receiving highly emetogenic chemotherapy. Data on fosaprepitant during autoHSCT in children are currently not available. Methods A total of 35 consecutive pediatric patients, who received an antiemetic prophylaxis with fosaprepitant (4 mg/kg; single dose, max. 1 x 150 mg/kg BW) and ondansetron (24-hours continuous infusion; 8–32 mg/24h) or granisetron (2 x 40 µg/kg∙d−1) during highly emetogenic conditioning chemotherapy before autoHSCT were retrospectively analyzed, and their results were compared with a control group comprising 35 consecutive pediatric patients, who received granisetron or ondansetron only. The antiemetic efficacy and the safety of the two prophylaxis regimens were compared with respect to three time periods after the first chemotherapy administration (0–24h, >24–120h, >120–240h). Results Clinical adverse events and clinically relevant increases/decreases of laboratory markers were similarly low and did not significantly differ between the two study groups (p>0.05). The registered number of vomiting events was significantly higher in the control group in the time periods of 0–24h (64 vs 22 events; p<0.01), >24–120h (135 vs 78 events; p<0.0001), >120–240h (268 vs 105 events; p<0.0001), and the whole observation period 0–240h (467 vs 205 events; p<0.0001). The percentage of patients experiencing vomiting was higher in the control group during the time period of >24–120h (100% vs 74.3%) but not the other analyzed time periods (p>0.05). Conclusion The fosaprepitant-based antiemetic prophylaxis was safe, well tolerated and significantly reduced vomiting in children undergoing highly emetogenic chemotherapy prior to autoHSCT. Prospective randomized trials are necessary to confirm these results.
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Affiliation(s)
| | - Semjon Willier
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. Von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Julia Vek
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Patrick Schlegel
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Manon Queudeville
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Nora Rieflin
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Veronika Klaus
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Melanie Gansel
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Joachim Vincent Rupprecht
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Tim Flaadt
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Vera Binder
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. Von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Tobias Feuchtinger
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. Von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Peter Lang
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Rupert Handgretinger
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Michaela Döring
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany
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Antiemetic prophylaxis with fosaprepitant and granisetron in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation. J Cancer Res Clin Oncol 2020; 146:1089-1100. [PMID: 32056007 PMCID: PMC7085480 DOI: 10.1007/s00432-020-03143-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/30/2020] [Indexed: 12/27/2022]
Abstract
Background
Chemotherapy-induced nausea and vomiting (CINV) is a severe and distressing complication during allogeneic hematopoietic stem cell transplantation (alloHSCT). The antiemetic fosaprepitant has shown favorable results in pediatric and adult patients receiving chemotherapy. Data on fosaprepitant in children and adolescents undergoing alloHSCT are missing. Methods In this non-interventional observation study, 120 children and adolescents with a median age of 11.8 years undergoing alloHSCT after a moderately or highly emetogenic conditioning (MEC or HEC) were analyzed. They received an antiemetic prophylaxis with granisetron (2 × 40 µg/kg d−1) with or without fosaprepitant (4 mg/kg; single dose, max. 1 × 150 mg/kg BW), and were analyzed in the control (CG; n = 60) or fosaprepitant group (FG; n = 60). The efficacy and safety of the two antiemetic prophylaxis regimens were analyzed and compared with respect to the acute (0–24 h) and the delayed (> 24–120 h) CINV phase and > 120–240 h after MEC or HEC administration. Results During MEC, significantly more patients in the CG experienced vomiting during the first 0–24 h (58.6 vs. 25.0%; p = 0.0156) and during > 24–120 h (93.1% vs. 57.1%; p = 0.0020), compared with the FG. Likewise, significantly more vomiting events (269 vs. 136; p < 0.0001) were registered in the CG. During HEC, significantly more patients in the CG experienced vomiting during the first 0–24 h (32.3 vs. 9.4%; p = 0.0319) compared with the FG. Significantly more vomiting events (241 vs. 99; p < 0.0001) were registered in the CG. Laboratory and clinical adverse events were not significantly different between the two groups (p > 0.05). Conclusions Antiemetic prophylaxis with fosaprepitant and granisetron was well tolerated, safe, and effective in pediatric patients undergoing alloHSCT. However, larger prospective trials are necessary to evaluate these findings. Electronic supplementary material The online version of this article (10.1007/s00432-020-03143-8) contains supplementary material, which is available to authorized users.
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Cabanillas Stanchi KM, Ebinger M, Hartmann U, Queudeville M, Feucht J, Ost M, Koch MS, Malaval C, Mezger M, Schober S, Weber S, Michaelis S, Lange V, Lang P, Handgretinger R, Döring M. Efficacy, Safety And Feasibility Of Antiemetic Prophylaxis With Fosaprepitant, Granisetron And Dexamethasone In Pediatric Patients With Hemato-Oncological Malignancies. DRUG DESIGN DEVELOPMENT AND THERAPY 2019; 13:3439-3451. [PMID: 31686784 PMCID: PMC6777642 DOI: 10.2147/dddt.s214264] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/29/2019] [Indexed: 01/18/2023]
Abstract
Background Chemotherapy-induced nausea and vomiting (CINV) are a major burden for patients undergoing emetogenic chemotherapy. International guidelines recommend an antiemetic prophylaxis with corticosteroids, 5-HT3R-antagonists and NK1R-antagonists. The NK1R-antagonist fosaprepitant has shown favorable results in pediatric and adult patients. There is little pediatric experience with fosaprepitant. Methods This non-interventional observation study analyzed 303 chemotherapy courses administered to 83 pediatric patients with a median age of 9 years (2-17 years), who received antiemetic prophylaxis either with fosaprepitant and granisetron with or without dexamethasone (fosaprepitant group/FG; n=41), or granisetron with or without dexamethasone (control group/CG; n=42), during moderately (CINV risk 30-90%) or highly (CINV risk>90%) emetogenic chemotherapy. The two groups' results were compared with respect to the safety and efficacy of the antiemetic prophylaxis during the acute (0-24hrs after chemotherapy), delayed (>24-120hrs after chemotherapy) and both CINV phases. Laboratory and clinical adverse events were compared between the two cohorts. Results Adverse events were not significantly different in the two groups (p>0.05). Significantly fewer vomiting events occurred during antiemetic prophylaxis with fosaprepitant in the acute (23 vs 142 events; p<0.0001) and the delayed (71 vs 255 events; p<0.0001) CINV phase. In the control group, the percentage of chemotherapy courses with vomiting was significantly higher during the acute (24%/FG vs 45%/CG; p<0.0001) and delayed CINV phase (28%/FG vs 47%/CG; p=0.0004). Dimenhydrinate (rescue medication) was administered significantly more often in the CG, compared to the FG (114/FG vs 320/CG doses; p<0.0001). Likewise, in the control group, dimenhydrinate was administered in significantly more (p<0.0001) chemotherapy courses during the acute and delayed CINV phases (79 of 150; 52.7%), compared to the fosaprepitant group (45 of 153; 29.4%). Conclusion Antiemetic prophylaxis with fosaprepitant and granisetron with or without dexamethasone was well tolerated, safe and effective in pediatric patients. However, larger prospective trials are needed to evaluate these findings.
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Affiliation(s)
| | - Martin Ebinger
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Ulrike Hartmann
- University Pharmacy, Eberhard-Karls-University of Tübingen, Tübingen 72076, Germany
| | - Manon Queudeville
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Judith Feucht
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Michael Ost
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Marie-Sarah Koch
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Carmen Malaval
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Markus Mezger
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Sarah Schober
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Simone Weber
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Sebastian Michaelis
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Veit Lange
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Peter Lang
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Rupert Handgretinger
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
| | - Michaela Döring
- Department of General Pediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Tübingen 72076, Germany
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Navari RM. HTX-019: polysorbate 80- and synthetic surfactant-free neurokinin 1 receptor antagonist for chemotherapy-induced nausea and vomiting prophylaxis. Future Oncol 2018; 15:241-255. [PMID: 30304952 DOI: 10.2217/fon-2018-0577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chemotherapy-induced nausea and vomiting (CINV) may occur during the acute (0-24 h) or delayed (25-120 h) phase following chemotherapy administration. The addition of a neurokinin 1 receptor antagonist to antiemetic regimens containing a 5-hydroxytryptamine type 3 receptor antagonist and dexamethasone has resulted in improved CINV prophylaxis. Due to numerous adverse events and hypersensitivity reactions associated with fosaprepitant, a commonly used neurokinin 1 receptor antagonist, there remains an unmet need for better-tolerated formulations. HTX-019, the US FDA-approved polysorbate 80- and synthetic surfactant-free aprepitant injectable emulsion, is bioequivalent to and better tolerated (fewer treatment-emergent adverse events) than fosaprepitant. HTX-019 represents a valuable alternative to fosaprepitant for CINV prophylaxis.
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Affiliation(s)
- Rudolph M Navari
- Department of Medicine, University of Alabama Birmingham, 1802 Sixth Avenue, North Pavilion 2540K, Birmingham, AL 35294, USA
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Gonçalves SC, Sanches SM, Bueno CT, Villela de Castro DL, Damascena A, Santos GRC. Incidence of Infusion Site Reactions in Peripheral Fosaprepitant Infusions. JOURNAL OF INFUSION NURSING 2017; 40:380-383. [PMID: 29112587 DOI: 10.1097/nan.0000000000000252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Fosaprepitant is administered intravenously to treat chemotherapy-induced nausea and vomiting. To verify the incidence of infusion site reactions and the relationship among risk factors, a quantitative retrospective cohort study was undertaken. The study included patients seen between October 2013 and February 2014. Fifty-seven patients were included in the study, and there were 105 infusions among them. Infusion site reactions were identified in 42 (40%) cases. Risk factors identified by the study included age (P < .001), insertion at the back of the hand and wrist (P < .001), and first fosaprepitant administration (P < .001). The study found evidence of a higher incidence of infusion site reactions than was reported in the package insert.
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Affiliation(s)
- Sarah C Gonçalves
- A.C. Camargo Cancer Center, São Paulo, Brazil. Sarah C. Gonçalves, MSc, RN, is a nurse coordinator at the AC Camargo Cancer Center in São Paulo, Brazil. Solange M. Sanches, MD, PhD, is head of the Clinical Oncology Department at the AC Camargo Cancer Center in São Paulo, Brazil. Camila T. Bueno, RN, is an oncology nurse in the Chemotherapy Center at the A.C. Camargo Cancer Center in São Paulo, Brazil. Diana L. Villela de Castro, PhD, RN, is a senior nurse in the Continuing Education Department at the A.C. Camargo Cancer Center in São Paulo, Brazil. Aline Damascena, MSc, BS, is a statistician at the A.C. Camargo Cancer Center in São Paulo, Brazil. Giseli R.C. Santos, RN, is a nurse coordinator in the Risk Management Department of the A.C. Camargo Cancer Center in São Paulo, Brazil
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Anestin AS, Dupuis G, Lanctôt D, Bali M. The Effects of the Bali Yoga Program for Breast Cancer Patients on Chemotherapy-Induced Nausea and Vomiting: Results of a Partially Randomized and Blinded Controlled Trial. J Evid Based Complementary Altern Med 2017; 22:721-730. [PMID: 28470117 PMCID: PMC5871279 DOI: 10.1177/2156587217706617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Complementary and alternative medicine has been shown to be beneficial in reducing chemotherapy-induced nausea and vomiting. However, conclusive results are lacking in order to confirm its usefulness. The purpose of this study was to determine whether a standardized yoga intervention could reduce these adverse symptoms. This was a partially randomized and blinded controlled trial comparing a standardized yoga intervention with standard care. Eligible patients were adults diagnosed with stages I to III breast cancer receiving chemotherapy. Patients randomized to the experimental group participated in an 8-week yoga program. There was no significant difference between the experimental and control groups on chemotherapy-induced nausea and vomiting after 8 weeks. Results suggest the yoga program is not beneficial in managing these adverse symptoms. However, considering preliminary evidence suggesting yoga’s beneficial impact in cancer symptom management, methodological limitations should be explored and additional studies should be conducted.
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Affiliation(s)
| | - Gilles Dupuis
- 1 Universite du Quebec a Montreal, Montreal, Quebec, Canada
| | | | - Madan Bali
- 2 Yoga Bliss Studio, Montreal, Quebec, Canada
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Prasoon P, Gupta S, Kumar R, Gautam M, Kaler S, Ray SB. Role of fosaprepitant, a neurokinin Type 1 receptor antagonist, in morphine-induced antinociception in rats. Indian J Pharmacol 2016; 48:394-398. [PMID: 27756950 PMCID: PMC4980927 DOI: 10.4103/0253-7613.186198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 06/08/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Opioids such as morphine form the cornerstone in the treatment of moderate to severe pain. However, opioids also produce serious side effects such as tolerance. Fosaprepitant is a substance P (SP) receptor antagonist, which is used for treating chemotherapy-induced nausea and vomiting. SP is an important neuropeptide mediating transmission of pain at the spinal level. Thus, it was hypothesized that combining morphine with fosaprepitant would increase the antinociceptive effect of morphine. The objectives were to evaluate the effect of fosaprepitant on morphine-induced antinociception in rats and to investigate its mechanism of action. METHODS Sprague-Dawley rats were injected with morphine (10 mg/kg twice daily) and/or fosaprepitant (30 mg/kg once daily) for 7 days. Pain threshold was assessed by the hot plate test. Expression of SP and calcitonin gene-related peptide (CGRP) in the spinal cords of these rats was evaluated by immunohistochemistry. RESULTS Morphine administration resulted in an antinociceptive effect compared to the control group (day 1 and to a lesser extent on day 4). The decreased antinociception despite continued morphine treatment indicated development of tolerance. Co-administration of fosaprepitant attenuated tolerance to morphine (days 1 and 3) and increased the antinociceptive effect compared to control group (days 1-4). Expression of SP was increased in the morphine + fosaprepitant group. CONCLUSIONS The results show that fosaprepitant attenuates the development of tolerance to morphine and thereby, increases the antinociceptive effect. This is likely linked to decreased release of SP from presynaptic terminals.
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Affiliation(s)
- Pranav Prasoon
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Shivani Gupta
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Kumar
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Mayank Gautam
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Saroj Kaler
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Subrata Basu Ray
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
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Candelario N, Lu MLR. Fosaprepitant dimeglumine for the management of chemotherapy-induced nausea and vomiting: patient selection and perspectives. Cancer Manag Res 2016; 8:77-82. [PMID: 27382332 PMCID: PMC4922819 DOI: 10.2147/cmar.s93620] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Chemotherapy-induced nausea and vomiting (CINV) is a debilitating side effect of antineoplastic agents. Several treatment regimens are used to address this problem. Fosaprepitant is a neurokinin-1 receptor blocker used in the prevention and treatment of CINV, especially for moderately and severely emetogenic chemotherapy. It is highly effective in the treatment of delayed CINV. Data from previous studies show that fosaprepitant is noninferior to aprepitant in the management of CINV. Fosaprepitant is given as a single-dose intravenous infusion, thus offering better patient compliance. The dose-limiting side effect of fosaprepitant is an infusion-related reaction, ranging from pain at the infusion site to thrombophlebitis. This side effect has been reported with coadministration of anthracycline agents.
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Rapoport B, Chua D, Poma A, Arora S, Wang Y, Fein LE. Study of rolapitant, a novel, long-acting, NK-1 receptor antagonist, for the prevention of chemotherapy-induced nausea and vomiting (CINV) due to highly emetogenic chemotherapy (HEC). Support Care Cancer 2015; 23:3281-8. [DOI: 10.1007/s00520-015-2738-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/06/2015] [Indexed: 11/24/2022]
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An analysis of fosaprepitant-induced venous toxicity in patients receiving highly emetogenic chemotherapy. Support Care Cancer 2014; 23:55-9. [PMID: 24964876 DOI: 10.1007/s00520-014-2326-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 06/16/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Fosaprepitant is an antiemetic used for chemotherapy-induced nausea and vomiting. We recently reported increased infusion site adverse events (ISAE) in a cohort of breast cancer patients receiving chemotherapy with doxorubicin and cyclophosphamide (AC). In this current study, we evaluated the venous toxicity of fosaprepitant use with non-anthracycline platinum-based antineoplastic regimens. METHODS A retrospective review was conducted of the first 81 patients initiated on fosaprepitant among patients receiving highly emetogenic chemotherapy, on or after January 1, 2011 at Mayo Clinic Rochester. None of these regimens included an anthracycline. Data collected included baseline demographics, chemotherapy regimen, type of intravenous access and type, and severity of ISAE. Data from these patients were compared to previously collected data from patients who had received AC. Statistical analysis using χ 2 and univariate logistic regression was used to evaluate the association between treatment regimen, fosaprepitant, and risk of ISAE. RESULTS Among these 81 patients, the incidence of ISAE was 7.4% in the non-anthracycline platinum group. The most commonly reported ISAE were swelling (3%), extravasation (3%), and phlebitis (3%). When stratified by regimen, fosaprepitant was associated with a statistically significant increased risk of ISAE in the anthracycline group (OR 8.1; 95% CI 2.0-31.9) compared to the platinum group. CONCLUSIONS Fosaprepitant antiemetic therapy causes significant ISAE that are appreciably higher than previous reports. Patients receiving platinum-based chemotherapy appear to have less significant ISAE than do patients who receive anthracycline-based regimens.
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de Mello RA, Gerós S, Alves MP, Moreira F, Avezedo I, Dinis J. Cetuximab plus platinum-based chemotherapy in head and neck squamous cell carcinoma: a retrospective study in a single comprehensive European cancer institution. PLoS One 2014; 9:e86697. [PMID: 24516537 PMCID: PMC3916324 DOI: 10.1371/journal.pone.0086697] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 12/11/2013] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The use of cetuximab in combination with platinum (P) plus 5-fluorouracil (F) has previously been demonstrated to be effective in the treatment of metastatic squamous cell cancer of head and neck (SCCHN). We investigated the efficacy and outcome of this protocol as a first-line treatment for patients with recurrent or metastatic disease. We evaluated overall-survival (OS), progression-free-survival (PFS), overall response rate (ORR) and the treatment toxicity profile in a retrospective cohort. PATIENTS AND METHODS This study enrolled 121 patients with untreated recurrent or metastatic SCCHN. The patients received PF+ cetuximab every 3 weeks for a maximum of 6 cycles. Patients with stable disease who received PF+ cetuximab continued to receive cetuximab until disease progressed or unacceptable toxic effects were experienced, whichever occurred first. RESULTS The median patient age was 53 (37-78) years. The patient cohort was 86.8% male. The addition of cetuximab to PF in the recurrent or metastatic setting provided an OS of 11 months (Confidential Interval, CI, 95%, 8.684-13.316) and PFS of 8 months (CI 95%, 6.051-9.949). The disease control rate was 48.9%, and the ORR was 23.91%. The most common grade 3 or 4 adverse events in the PF+ cetuximab regimen were febrile neutropenia (5.7%), skin rash (3.8%) and mucosistis (3.8%). CONCLUSIONS The results of this study suggest that cetuximab plus platinum-fluorouracil chemotherapy is a good option for systemic treatment in advanced SSCHN patients. This regimen has a well-tolerated toxicity profile.
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Affiliation(s)
- Ramon Andrade de Mello
- Department of Medical Oncology, Head and Neck Unit, Portuguese Oncology Institute, Porto, Portugal
- Department of Medicine and Biomedical Sciences, School of Medicine, University of Algarve, Faro, Portugal
- Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sandra Gerós
- Service of Otorhinolaryngology, Head and Neck Unit, Portuguese Oncology Institute, Porto, Portugal
- Department of Otorhinolaryngology and Cervical Facial Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marcos Pantarotto Alves
- Department of Medical Oncology, Head and Neck Unit, Portuguese Oncology Institute, Porto, Portugal
| | - Filipa Moreira
- Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Isabel Avezedo
- Department of Medical Oncology, Head and Neck Unit, Portuguese Oncology Institute, Porto, Portugal
| | - José Dinis
- Department of Medical Oncology, Head and Neck Unit, Portuguese Oncology Institute, Porto, Portugal
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Assessing physico-chemical compatibility of concomitantly diluted antiemetics including palonosetron-HCl and fosaprepitant dimeglumine. Cancer Chemother Pharmacol 2013; 73:435-6. [PMID: 24220934 DOI: 10.1007/s00280-013-2331-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 10/16/2013] [Indexed: 10/26/2022]
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