阿瑞匹坦作为挽救疗法用于对5-羟色胺(3)拮抗剂和地塞米松预防性治疗难治的化疗引起的恶心和呕吐患者。

Aprepitant as salvage therapy in patients with chemotherapy-induced nausea and emesis refractory to prophylaxis with 5-HT(3) antagonists and dexamethasone.

作者信息

Oechsle Karin, Müller Martin R, Hartmann Jörg T, Kanz Lothar, Bokemeyer Carsten

机构信息

Medizinische Klinik und Poliklinik II, Abteilung für Hämatologie / Onkologie / Immunologie / Rheumatologie / Pulmonologie, Universitätsklinik Tübingen, Germany.

出版信息

Onkologie. 2006 Dec;29(12):557-61. doi: 10.1159/000096689. Epub 2006 Dec 11.

DOI:10.1159/000096689

PMID:17202825

Abstract

BACKGROUND

Despite prophylaxis with 5-HT(3) antagonists and dexamethasone, nausea/emesis are common chemotherapy- induced toxicities. The aim of this trial was to evaluate the efficacy of adding the NK1 antagonist aprepitant in patients refractory to standard prophylaxis.

PATIENTS AND METHODS

Patients with significant nausea/vomiting despite prophylaxis with 5-HT(3) antagonists and dexamethasone were eligible. Aprepitant was added to the same antiemetic regimen used during previous cycles.

RESULTS

34 patients received 92 cycles of chemotherapy with aprepitant which was applied orally at 125 mg on day 1 and 80 mg on days 2 and 3. All patients were refractory to standard antiemetic prophylaxis during cisplatin-based (n = 12) or other chemotherapy (n = 22). With the addition of aprepitant, all patients reported subjective improvement. The number of patients with nausea for >4 days decreased from 24 (71%) to 4 (12%) (p < 0.001), and the number of those with emesis for >2 days decreased from 26 (77%) to 0 (0%) (p < 0.001). In 12 patients receiving aprepitant for >2 cycles (3-8) the efficacy was maintained. No toxicity possibly related to aprepitant was observed.

CONCLUSION

Aprepitant demonstrated significant activity in patients with nausea/vomiting refractory to prophylaxis with 5-HT(3) antagonists and dexamethasone.

摘要

背景

尽管使用了5-羟色胺（3）拮抗剂和地塞米松进行预防，恶心/呕吐仍是常见的化疗引起的毒性反应。本试验的目的是评估在对标准预防措施无效的患者中添加NK1拮抗剂阿瑞匹坦的疗效。

患者与方法

尽管使用了5-羟色胺（3）拮抗剂和地塞米松预防，但仍有明显恶心/呕吐的患者符合入选标准。将阿瑞匹坦添加到上一周期使用的相同止吐方案中。

结果

34例患者接受了92周期含阿瑞匹坦的化疗，阿瑞匹坦于第1天口服125mg，第2天和第3天口服80mg。所有患者在基于顺铂的化疗（n = 12）或其他化疗（n = 22）期间对标准止吐预防措施均无效。添加阿瑞匹坦后，所有患者均报告主观症状有所改善。恶心超过4天的患者数量从24例（71%）降至4例（12%）（p < 0.001），呕吐超过2天的患者数量从26例（77%）降至0例（0%）（p < 0.001）。12例接受阿瑞匹坦超过2周期（3 - 8周期）的患者疗效得以维持。未观察到可能与阿瑞匹坦相关的毒性反应。