A combination of aprepitant, palonosetron, and dexamethasone prevents emesis associated with anthracycline-containing regimens for patients with breast cancer. A retrospective study.

BACKGROUND

Chemotherapy regimens for breast cancer containing anthracycline and cyclophosphamide are classified as highly emetogenic. Aprepitant (A), palonosetron (P), granisetron (G), or dexamethasone (D) are recommended antiemetic drugs. However, it is uncertain which combination is most effective. We retrospectively examined the efficacy of these antiemetic drugs.

PATIENTS AND METHODS

We reviewed the medical records of 454 patients with breast cancer treated in our facility with regimens containing anthracycline and cyclophosphamide between August 2009 and September 2010.

RESULT

The number of patients treated with GD, AGD, and APD was 147, 150, and 157, respectively. Complete response (CR) in the acute (0-24 h) and delayed (24-120 h) phases was 68.7 and 76.2 %, respectively, for GD, 90.0 and 92.7 %, respectively, for AGD, and 89.8 and 90.4 %, respectively, for APD. Complete control (CC) in the acute and delayed phases for each regimen was 60.5 and 64.6 %, respectively, for GD, 62.7 and 88.7 %, respectively, for AGD, and 84.1 and 87.3 %, respectively, for APD. In the acute and delayed phases CR for AGD or APD was significantly superior to that for GD (P < 0.01). It worth noting that CC for APD in the acute phase was significantly superior to that for AGD (P < 0.01). In the delayed phase CC for AGD or APD was significantly superior to that for GD.

CONCLUSION

A combination of aprepitant, palonosetron, and dexamethasone is an antiemetic treatment of choice for patients treated with regimens containing anthracycline and cyclophosphamide.