Journal of Gastroenterology

, Volume 48, Issue 11, pp 1234–1241 | Cite as

Aprepitant plus granisetron and dexamethasone for prevention of chemotherapy-induced nausea and vomiting in patients with gastric cancer treated with S-1 plus cisplatin

  • Katsunobu Oyama
  • Sachio Fushida
  • Masahide Kaji
  • Toshiya Takeda
  • Shinichi Kinami
  • Yasuo Hirono
  • Katsuhiro Yoshimoto
  • Kazuhisa Yabushita
  • Hisashi Hirosawa
  • Yuki Takai
  • Tatsuo Nakano
  • Hironobu Kimura
  • Toshiaki Yasui
  • Atsushi Tsuneda
  • Tomoya Tsukada
  • Jun Kinoshita
  • Takashi Fujimura
  • Tetsuo Ohta
Original Article—Alimentary Tract

Abstract

Background

We aimed to evaluate the efficacy of a new combination antiemetic therapy comprising aprepitant, granisetron, and dexamethasone in gastric cancer patients undergoing chemotherapy with cisplatin and S-1.

Methods

Gastric cancer patients scheduled to receive their first course of chemotherapy with cisplatin (60 mg/m2) and S-1 (80 mg/m2) were treated with a new combination antiemetic therapy aprepitant, granisetron, and dexamethasone on day 1; aprepitant and dexamethasone on days 2 and 3; and dexamethasone on day 4. The patients reported vomiting, nausea, use of rescue therapy, and change in the amount of diet intake, and completed the Functional Living Index-Emesis (FLIE) questionnaire. The primary endpoint was complete response (CR; no emesis and use of no rescue antiemetics) during the overall study phase (0–120 h after cisplatin administration). The secondary endpoints included complete protection (CP; CR plus no significant nausea); change in the amount of diet intake; and the impact of chemotherapy-induced nausea and vomiting (CINV) on daily life during the overall, acute (0–24 h), and delayed (24–120 h) phases.

Results

Fifty-three patients were included. CR was achieved in 88.7, 98.1, and 88.7 % of patients in the overall, acute, and delayed phases, respectively. The corresponding rates of CP were 67.9, 96.2, and 67.9 %. Approximately half of the patients had some degree of anorexia. FLIE results indicated that 79.5 % of patients reported “minimal or no impact of CINV on daily life”.

Conclusions

Addition of aprepitant to standard antiemetic therapy was effective in gastric cancer patients undergoing treatment with cisplatin and S-1.

Keywords

Aprepitant Gastric cancer CINV Anorexia QOL 

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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Katsunobu Oyama
    • 1
  • Sachio Fushida
    • 1
  • Masahide Kaji
    • 2
  • Toshiya Takeda
    • 3
  • Shinichi Kinami
    • 4
  • Yasuo Hirono
    • 5
  • Katsuhiro Yoshimoto
    • 6
  • Kazuhisa Yabushita
    • 7
  • Hisashi Hirosawa
    • 8
  • Yuki Takai
    • 9
  • Tatsuo Nakano
    • 10
  • Hironobu Kimura
    • 11
  • Toshiaki Yasui
    • 12
  • Atsushi Tsuneda
    • 13
  • Tomoya Tsukada
    • 1
  • Jun Kinoshita
    • 1
  • Takashi Fujimura
    • 1
  • Tetsuo Ohta
    • 1
  1. 1.Department of Gastroenterological SurgeryKanazawa UniversityKanazawaJapan
  2. 2.Department of SurgeryToyama Prefectural Central HospitalToyamaJapan
  3. 3.Department of SurgeryPublic Central Hospital of Matto IshikawaHakusanJapan
  4. 4.Department of General and Digestive SurgeryKanazawa Medical UniversityKahokuJapan
  5. 5.First Department of SurgeryUniversity of FukuiFukuiJapan
  6. 6.Department of SurgeryToyama Rosai HospitalUozuJapan
  7. 7.Department of SurgeryTakaoka City HospitalTakaokaJapan
  8. 8.Department of SurgeryToyama City HospitalToyamaJapan
  9. 9.Department of GastroenterologyKeiju Medical CenterNanaoJapan
  10. 10.Department of SurgeryAsanogawa General HospitalKanazawaJapan
  11. 11.Department of SurgeryNTT West Kanazawa HospitalKanazawaJapan
  12. 12.Department of SurgeryKanazawa Social Insurance HospitalKanazawaJapan
  13. 13.Department of SurgeryKurobe City HospitalKurobeJapan

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