Phase II study of palonosetron, aprepitant and dexamethasone to prevent nausea and vomiting induced by multiple-day emetogenic chemotherapy

This study aimed to determine the antiemetic efficacy and safety of palonosetron, aprepitant and dexamethasone in patients with testicular germ cell tumours (TGCTs) receiving 5-day cisplatin-based combination chemotherapy.

In this open-label, single-arm, single-centre study, the antiemetic therapy consisted of palonosetron 0.75 mg on day 1, aprepitant 125 mg on day 1 and 80 mg on days 2-7 and dexamethasone 6.6 mg on days 1-7. The primary endpoint was complete response (CR; no vomiting/retching or rescue medication) in the overall period (0-240 h), and secondary endpoints included complete protection (CP; defined as CR and no more than mild nausea) and total control (TC; defined as CR and no nausea). The incidence and severity of nausea were assessed on the basis of the Common Terminology Criteria for Adverse Events v4.0 and a subjective rating scale completed by patients.

Twenty-five patients were enrolled and evaluated for safety, and 24 patients were evaluated for efficacy. CR was achieved in 62.5% of patients (95% confidence interval [CI] = 40.6-81.2, p = 0.043) in the overall period. CP and TC were achieved in 62.5% (95% CI = 40.6-81.2) and 25.0% of patients (95% CI = 9.8-46.7), respectively, in the overall period. The primary adverse drug reaction was hiccups (48.0%). The events were expected, and none was grade 3 or 4.

The examined combination antiemetic therapy was effective and well-tolerated in patients with TGCTs receiving 5-day cisplatin-based combination chemotherapy.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2017 Nov 16 [Epub ahead of print]

Takeshi Ioroi, Junya Furukawa, Manabu Kume, Sachi Hirata, Yuko Utsubo, Naomi Mizuta, Hideaki Miyake, Masato Fujisawa, Midori Hirai

Department of Pharmacy, Kobe University Hospital, 7-5-2 Kusunoki-Cho, Kobe City, Hyogo, 650-0017, Japan. ., Division of Urology, Graduate School of Medicine, Kobe University, Kobe, Japan., Department of Pharmacy, Kobe University Hospital, 7-5-2 Kusunoki-Cho, Kobe City, Hyogo, 650-0017, Japan., Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

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