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Inano H, Morimoto Y, Kitagawa K, Shibuya A, Nakagomi K, Ota T, Anzo Y, Miyauchi R, Shono A, Watanabe K, Otori K. Comparing the Efficacy of Fosnetupitant, an NK 1 Receptor Antagonist in CDDP-Based Regimens, with That of Fosaprepitant and Aprepitant: A Retrospective Observational Study. Biol Pharm Bull 2024; 47:692-697. [PMID: 38417893 DOI: 10.1248/bpb.b23-00819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
Existing antiemetic therapy against emetic-risk agents across malignancies 24 h post-dose in the acute period in cisplatin (CDDP)-based regimens yields a satisfactory complete response (CR) rate of ≥90%. However, the control rate after 24 h in the delayed period is unsatisfactory. This study compared the efficacy of fosnetupitant (F-NTP), a neurokinin 1 receptor antagonist, with that of fosaprepitant (F-APR) and aprepitant (APR) in the treatment of patients with cancer at high emetic risk due to chemotherapy. In this retrospective case-control study involving patients receiving cisplatin-containing regimens and neurokinin 1 receptor antagonists, patients were divided into three groups based on prophylactic antiemetic therapy: F-NTP, F-APR, and APR. The CR rate was evaluated for each period up to 168 h and further subdivided into acute (0-24 h), delayed (24-120 h), overall (0-120 h), and beyond-delayed (120-168 h) periods. Eighty-eight patients were included in the F-NTP group, 66 in the F-APR group, and 268 in the APR group. The CR rates at 0-168 and 120-168 h after cisplatin administration were significantly higher in the F-NTP group than in the F-APR and APR groups. After adjusting for confounding factors, F-NTP use was an independent factor in the multivariate analysis. Prophylactic antiemetic therapy, including F-NTP, was effective and well-tolerated during the delayed period. The efficacy of F-NTP in managing chemotherapy-induced nausea and vomiting was superior to those of F-APR and APR during the study period.
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Affiliation(s)
- Hiroshi Inano
- Department of Pharmacy, Kitasato University Hospital
| | - Yoshihito Morimoto
- Education and Research Center for Clinical Pharmacy, Showa Pharmaceutical University
| | | | - Akito Shibuya
- Department of Pharmacy, Kitasato University Hospital
| | | | - Tomohiro Ota
- Department of Pharmacy, Kitasato University Hospital
| | - Yuri Anzo
- Department of Pharmacy, Kitasato University Hospital
| | - Rika Miyauchi
- Education and Research Center for Clinical Pharmacy, Showa Pharmaceutical University
| | - Aiko Shono
- Laboratory of Social Pharmacy and Regulatory Science, Showa Pharmaceutical University
| | - Kazuhiro Watanabe
- Education and Research Center for Clinical Pharmacy, Showa Pharmaceutical University
| | - Katsuya Otori
- Department of Pharmacy, Kitasato University Hospital
- Laboratory of Pharmacy Practice and Science I, Research and Education Center for Clinical Pharmacy, School of Pharmacy, Kitasato University
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Roila F, Ruggeri B, Ballatori E, Fatigoni S, Caserta C, Licitra L, Mirabile A, Ionta MT, Massidda B, Cavanna L, Palladino MA, Tocci A, Fava S, Colantonio I, Angelelli L, Ciuffreda L, Fasola G, Zerilli F. Aprepitant versus metoclopramide, both combined with dexamethasone, for the prevention of cisplatin-induced delayed emesis: a randomized, double-blind study. Ann Oncol 2015; 26:1248-1253. [PMID: 25743855 DOI: 10.1093/annonc/mdv132] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 02/19/2015] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND A combination of aprepitant, a 5-HT3 receptor antagonist (r.a.), and dexamethasone is recommended for the prophylaxis of cisplatin-induced nausea and vomiting in the acute phase, and aprepitant + dexamethasone (A + D) in the delayed phase. The aim of this study was to verify if A + D is superior to metoclopramide plus dexamethasone (M + D) in preventing delayed emesis in cancer patients receiving the same prophylaxis for acute emesis. PATIENTS AND METHODS A randomized double-blind study comparing A + D versus M + D was completed in previously untreated cancer patients. Before chemotherapy, all patients were treated with intravenous palonosetron 0.25 mg and dexamethasone 12 mg, and oral aprepitant 125 mg. On day 2-4, patients randomly received oral dexamethasone 8 mg plus aprepitant 80 mg once daily (days 2-3) or metoclopramide 20 mg four times daily plus dexamethasone 8 mg bid. Primary endpoint was rate of complete response (no vomiting, no rescue treatment) in day 2-5 after chemotherapy. RESULTS Due to difficulty in the accrual of patients, 303 of the 480 planned patients were enrolled, 284 were fully evaluable, 147 receiving A + D, 137 M + D. Day 1 results were similar in both arms. On day 2-5, complete response rate was not significantly different (80.3% with A + D versus 82.5% with M + D, P < 0.38, respectively), and all secondary endpoints were also similar (complete protection, total control, no vomiting, no nausea, and score of Functional Living Index-Emesis; P < 0.24). Adverse events incidence was not significantly different between the two treatments. CONCLUSIONS In cancer patients submitted to cisplatin-based chemotherapy, receiving the same antiemetic prophylaxis for acute emesis, A + D is not superior to M + D in preventing delayed emesis, and both treatments present similar toxicity. CLINICALTRIALSGOV NUMBER NCT00869310.
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Affiliation(s)
- F Roila
- Medical Oncology Division, 'S. Maria' Hospital, Terni.
| | - B Ruggeri
- Clinical Governance, ASUR Marche, Ascoli Piceno
| | - E Ballatori
- Internal Medicine and Public Health, University of L'Aquila, Spinetoli
| | - S Fatigoni
- Medical Oncology Division, 'S. Maria' Hospital, Terni
| | - C Caserta
- Medical Oncology Division, 'S. Maria' Hospital, Terni
| | - L Licitra
- Medical Oncology, National Cancer Institute, Milano
| | - A Mirabile
- Medical Oncology, National Cancer Institute, Milano
| | - M T Ionta
- Medical Oncology II, University Hospital, Cagliari
| | - B Massidda
- Medical Oncology II, University Hospital, Cagliari
| | - L Cavanna
- Medical Oncology, Piacenza Hospital, Piacenza
| | | | - A Tocci
- Medical Oncology, Azienda Ospedaliera di Legnano, Legnano
| | - S Fava
- Medical Oncology, Azienda Ospedaliera di Legnano, Legnano
| | - I Colantonio
- Medical Oncology, Santa Croce e Carle Hospital, Cuneo
| | - L Angelelli
- Medical Oncology, ASUR Marche, Ascoli Piceno
| | - L Ciuffreda
- Medical Oncology, Molinette Hospital, Torino
| | - G Fasola
- Medical Oncology, University Hospital S. Maria della Misericordia, Udine
| | - F Zerilli
- Medical Oncology, S. Antonio Abate Hospital, Trapani, Italy
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Yamamoto K, Asano K, Tasaka A, Ogura Y, Kim S, Ito Y, Yamatodani A. Involvement of substance P in the development of cisplatin-induced acute and delayed pica in rats. Br J Pharmacol 2014; 171:2888-99. [PMID: 24641692 DOI: 10.1111/bph.12629] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 01/06/2014] [Accepted: 01/27/2014] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND PURPOSE Although substance P (SP) and neurokinin NK1 receptors have been reported to be involved in cisplatin-induced acute and delayed emesis, their precise roles remain unclear. Pica, the consumption of non-nutrient materials such as kaolin in rats, can be used as a model of nausea in humans. We investigated the time-dependent changes in cisplatin-induced pica and the involvement of SP and NK1 receptors in this behaviour. EXPERIMENTAL APPROACH Rats were administered cisplatin with or without a daily injection of a 5-HT3 receptor antagonist (granisetron) or an NK1 receptor antagonist (aprepitant), and kaolin intake was then monitored for 5 days. The effects of granisetron on the cisplatin-induced expression of preprotachykinin-A (PPT-A) mRNA, which encodes mainly for SP, and on SP release in the medulla, measured by in vivo brain microdialysis, were also investigated. KEY RESULTS Cisplatin induced pica within 8 h of its administration that continued for 5 days. Granisetron inhibited the acute phase (day 1), but not the delayed phase (days 2-5), of pica, whereas aprepitant abolished both phases. Within 24 h of the injection of cisplatin, PPT-A mRNA expression and SP release in the medulla were significantly increased; these findings lasted during the observation period and were inhibited by granisetron for up to 24 h. CONCLUSIONS AND IMPLICATIONS The profiles of cisplatin-induced pica in rats are similar to clinical findings for cisplatin-induced emesis in humans, and we showed that SP production in the medulla and activation of NK1 receptors are involved in this cisplatin-induced pica.
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Affiliation(s)
- Kouichi Yamamoto
- Department of Medical Science and Technology, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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Mizukami N, Yamauchi M, Koike K, Watanabe A, Ichihara K, Masumori N, Yamakage M. Olanzapine for the prevention of chemotherapy-induced nausea and vomiting in patients receiving highly or moderately emetogenic chemotherapy: a randomized, double-blind, placebo-controlled study. J Pain Symptom Manage 2014; 47:542-50. [PMID: 23856100 DOI: 10.1016/j.jpainsymman.2013.05.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 05/02/2013] [Accepted: 05/04/2013] [Indexed: 01/01/2023]
Abstract
CONTEXT Chemotherapy-induced nausea and vomiting (CINV) can severely impair patients' quality of life (QOL). Psychotropics, especially olanzapine, have a strong antiemetic effect. OBJECTIVES To determine whether olanzapine could reduce the frequency of CINV and improve patients' QOL during chemotherapy. METHODS This was a randomized, double-blind, placebo-controlled trial. Forty-four patients scheduled to receive highly or moderately emetogenic chemotherapy were enrolled. All patients received a 5-hydroxytryptamine3 receptor antagonist, steroid, and neurokinin-1 receptor antagonist. Patients were randomly assigned to take 5 mg/day of oral olanzapine (OL group, n = 22) or placebo (control group, n = 22) daily from the day before chemotherapy (Day 0) to Day 5. The primary endpoint was the rate of patients who achieved total control (no vomiting, no use of rescue medications, and maximum nausea of <5/100mm on a visual analogue scale). The secondary endpoint was Functional Living Index-Emesis questionnaire score on Days 0 and 6. RESULTS The rate of patients achieving total control was significantly higher in the OL group (86% and 64% in acute and delayed phases, respectively) than in the control group (55% and 23%, P = 0.045, P = 0.014, respectively). Furthermore, the OL group experienced a better QOL than the control group, as reported on the Functional Living Index-Emesis questionnaire (P = 0.0004). CONCLUSION The addition of 5mg/day of oral olanzapine to standard therapy can reduce the frequency of CINV and improve QOL of patients receiving highly or moderately emetogenic chemotherapy.
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Affiliation(s)
- Naomi Mizukami
- Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.
| | - Masanori Yamauchi
- Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Kazuhiko Koike
- Division of Palliative Medicine, Higashi-Sapporo Hospital, Sapporo, Hokkaido, Japan
| | - Akihiko Watanabe
- Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Koji Ichihara
- Department of Urologic Surgery and Andrology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urologic Surgery and Andrology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Michiaki Yamakage
- Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
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Abstract
1. Intravenously injected cisplatin at a dose of 4 mg kg(-1) induced early and delayed emesis in all pigeons without occurrence of lethality during a 72 h observation period. The early emetic response occurred with a latency of 81.3+/-8.0 min (n=15) and reached a peak at 2 - 3 h, and decreased gradually within 8 h after injection. Then the delayed emetic response, whose peak was found between 10 to 23 h, lasted up to 48 h. The emetic response markedly declined after 48 h. 2. Reserpine markedly reduced monoamine levels in both brain and intestine and completely abolished the early and delayed emesis. Dexamethasone markedly reduced not only the early but also the delayed emetic responses. p-Chlorophenylalanine decreased the level of serotonin in brain and intestine without affecting noradrenaline and dopamine and partly reduced the early emetic response, but did not affect delayed emesis. 3. Bilateral vagotomy prolonged the latency time to the onset of early emesis, and reduced the emetic responses in both the early and delayed phases. 4. The above results suggest that the cisplatin-induced early emesis in the pigeon is partially mediated via the vagal nerve and reserpine-sensitive monoaminergic systems including the serotonergic system; the delayed emesis is associated with monoaminergic but not the serotonergic systems.
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Affiliation(s)
- Sachiko Tanihata
- Department of Pharmacology, Toho University School of Medicine, Ota-ku, Tokyo 143-8540, Japan
| | - Hiroaki Igarashi
- Second Department of Anatomy, Toho University School of Medicine, Ota-ku, Tokyo 143-8540, Japan
| | - Masami Suzuki
- Department of Pharmacology, Toho University School of Medicine, Ota-ku, Tokyo 143-8540, Japan
| | - Toshimitsu Uchiyama
- Department of Pharmacology, Toho University School of Medicine, Ota-ku, Tokyo 143-8540, Japan
- Author for correspondence:
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Grélot L, Dapzol J, Estève E, Frugière A, Bianchi AL, Sheldrick RL, Gardner CJ, Ward P. Potent inhibition of both the acute and delayed emetic responses to cisplatin in piglets treated with GR205171, a novel highly selective tachykinin NK1 receptor antagonist. Br J Pharmacol 1998; 124:1643-50. [PMID: 9756379 PMCID: PMC1565571 DOI: 10.1038/sj.bjp.0702019] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The effects of GR205171, a selective tachykinin NK1 receptor antagonist, were investigated on both the acute and delayed phases of cisplatin-induced nausea-like behaviour and vomiting in the conscious piglet. Animals receiving cisplatin (5.5 mg kg(-1), i.v.) were observed for 60 h. Fifteen min prior to cisplatin infusion (T0(-15 min)), eight piglets acting as controls received an intravenous injection of saline solution (1 ml kg(-1)), whereas experimental animals received a single i.v. administration of GR205171 (1 ml kg(-1)) at a dose of 0.01 (n=8), 0.03 (n=8), 0.1 (n = 8), 0.3 (n = 16) or 1.0 (n = 13) mg kg(-1). In eight additional piglets, GR205171 (1 mg kg(-1)) was administered 15 min before the onset of the delayed phase (T16(-15 min)). A further five piglets received GR205171 (1 mg kg(-1)) every 6 h throughout the experiment. The latencies of the first emetic episode (EE) and nausea-like behavioural episode (NE) increased in all experimental groups treated at T0(-15 min), and the total number of both EE and NE during the 60 h was reduced in a dose-dependent manner. In piglets treated at T0(-15 min) with GR205171 1 mg kg(-1), eight out of 13 (62%) did not vomit throughout the experiment. Animals treated with GR205171 (1 mg kg(-1)) at T16(-15 min) exhibited an acute response to cisplatin but did not vomit during the delayed phase. The greatest inhibition of both nausea-like behaviour and vomiting was observed in piglets receiving multiple injections of GR205171. These results demonstrate the long-lasting anti-emetic effects of GR205171, and confirm the key role of substance P within the emetic reflex.
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Affiliation(s)
- L Grélot
- Département de Physiologie et Neurophysiologie (UPRES A CNRS 6034), Laboratoire de Neurophysiologie et Neurobiologie Fonctionnelles, Faculté des Sciences et Techniques St Jérôme, Marseille, France
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