NDLI: Safety, efficacy, and patient acceptability of single-dose fosaprepitant regimen for the prevention of chemotherapy-induced nausea and vomiting

Content Provider	PubMed Central
Author	Celio, Luigi Francesca, Ricchini Braud, Filippo De
Copyright Year	2013
Abstract	Control of chemotherapy-induced nausea and vomiting (CINV) is a crucial factor in ensuring that patients undergoing cancer chemotherapy can get the full benefit of therapy. Current antiemetic guidelines recommend that the neurokinin-1 receptor (NK-1R) antagonist aprepitant should be used as part of a combination regimen with dexamethasone and a serotonin receptor antagonist for the prevention of CINV in patients receiving highly emetogenic chemotherapy (HEC). Fosaprepitant is a water-soluble N-phosphoryl derivative of aprepitant that, when infused, is rapidly metabolized back to an active aprepitant. The existing literature in PubMed about fosaprepitant was screened and selected in order to address the emerging data from two randomized clinical trials evaluating the efficacy and safety of a single-dose fosaprepitant regimen. These phase III trials demonstrated that fosaprepitant given as a single intravenous dose of 150 mg was either noninferior to the conventional 3-day aprepitant or significantly superior to placebo for the prevention of acute and delayed CINV in patients receiving high-dose cisplatin. In both trials, fosaprepitant was well tolerated although more frequent infusion-site adverse events were observed with fosaprepitant. The new dosage regimen of fosaprepitant, therefore, would be an option for CINV control in patients receiving cisplatin-based chemotherapy. The clinical efficacy is consistent with the findings from a time-on-target, positron-emission tomography study evaluating the NK-1R occupancy in the central nervous system (CNS) over 5 days after a single-dose infusion of 150 mg fosaprepitant in healthy participants. The single-dose regimen is capable of blocking more than 90% of the NK-1Rs in the CNS for at least 48 hours after infusion, which is sufficient to control delayed CINV for 2 to 5 days after HEC. The new dosage regimen of fosaprepitant can provide a simplified treatment option that maintains high protection while ensuring adherence to scheduled antiemetic medication throughout most of the 5-day period encompassing the major risk for CINV.
Related Links	http://dx.doi.org/10.2147/ppa.s31288
Ending Page	400
Page Count	10
Starting Page	391
File Format	PDF
ISSN	1177889X
e-ISSN	1177889X
Journal	Patient preference and adherence
Volume Number	7
Language	English
Publisher	Dove Medical Press
Publisher Date	2013-05-01
Access Restriction	Open
Rights Holder	Dove Medical Press
Subject Keyword	Health Policy Social Sciences (miscellaneous) Medicine (miscellaneous) Pharmacology, Toxicology and Pharmaceutics (miscellaneous) Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Social Sciences Pharmacology, Toxicology and Pharmaceutics Health Policy

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