Skip to main content
Log in

Emesis control by aprepitant in children and adolescents with chemotherapy

  • Short Research Report
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Chemotherapy-induced nausea and vomiting (CINV) is a feared adverse reaction during cancer treatment. Aprepitant has shown to be effective for CINV in adults, but little is known on its effect in pediatrics. So far, the drug is not licensed in this population. Objective To investigate efficacy of aprepitant in children and young adolescents with high or moderate emetogenic courses, with uncontrollable emesis in previous cycles. Method Retrospective, observational study in children and adolescents treated with aprepitant at Ghent University Hospital, Belgium. Antiemetic regimens and emesis control were analyzed. Results Twenty patient charts representing 104 chemotherapy cycles were reviewed. Complete vomiting control was observed in 10 patients (50 %), representing 89/104 (85.6 %) episodes. Incomplete vomiting control was observed in 10 patients (50 %), representing only 15 episodes (14.4 %). Of these episodes with incomplete vomiting control, 6 were in acute phase (40 %), 7 in delayed phase (46.7 %) and 2 in both acute and delayed phase (13.3 %). Conclusion Aprepitant might be effective in preventing or reducing vomiting in children. When combined with standard antiemetics, aprepitant was well tolerated. In attendance of results of on-going international clinical trials, our results encourage us to continue the use of aprepitant after failure of emesis control in previous cycles.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Herrstedt J, Dombernowsky P. Anti-emetic therapy in cancer chemotherapy: current status. Basic Clin Pharmacol Toxicol. 2007;101(3):143–50.

    Article  PubMed  CAS  Google Scholar 

  2. Jordan K, Sippel C, Schmoll HJ. Guidelines for antiemetic treatment of chemotherapy-induced nausea and vomiting: past, present, and future recommendations. Oncologist. 2007;12(9):1143–50.

    Article  PubMed  CAS  Google Scholar 

  3. Gralla RJ, Osoba D, Kris MG, Kirkbride P, Hesketh PJ, Chinnery LW, et al. Recommendations for the use of antiemetics: evidence-based, clinical practice guidelines. American Society of Clinical Oncology. J Clin Oncol. 1999;17(9):2971–94.

    PubMed  CAS  Google Scholar 

  4. Holdsworth M, Raisch D, Frost J. Acute and delayed nausea and emesis control in pediatric oncology patients. Cancer. 2006;106(4):931–40.

    Article  PubMed  Google Scholar 

  5. Small BE, Holdsworth MT, Raisch DW, Winter SS. Survey ranking of emetogenic control in children receiving chemotherapy. J Pediatr Hematol Oncol. 2000;22(2):125–32.

    Article  PubMed  CAS  Google Scholar 

  6. Gore L, Chawla S, Petrilli A, Hemenway M, Schissel D, Chua V, et al. Aprepitant in adolescent patients for prevention of chemotherapy-induced nausea and vomiting: a randomized, double-blind, placebo-controlled study of efficacy and tolerability. Pediatr Blood Cancer. 2009;52:242–7.

    Article  PubMed  Google Scholar 

  7. Smith A, Repka T, Weigel B. Aprepitant for the control of chemotherapy induced nausea and vomiting in adolescents. Pediatr Blood Cancer. 2005;45:857–60.

    Article  PubMed  Google Scholar 

  8. Basch E, Prestrud AA, Hesketh PJ, Kris MG, Feyer PC, Somerfield MR, et al. American Society of Clinical Oncology. Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2011:1;29(31):4189–98.

    Google Scholar 

  9. Emend, Product Monograph. Available at http://www.merck.ca/assets/en/pdf/products/EMEND-PM_E.pdfAccessed June 26, 2012.

  10. Cuzzolin L, Zaccaron A, Fanos V. Unlicensed and off-label uses of drugs in paediatrics: a review of literature. Fundam Clin Pharmacol. 2003;17(1):125–31.

    Article  PubMed  CAS  Google Scholar 

  11. Choi MR, Jiles C, Seibel NL. Aprepitant use in children, adolescents, and young adults for the control of chemotherapy-induced nausea and vomiting (CINV). J Pediatr Hematol Oncol. 2010;32(7):e268–71.

    Article  PubMed  Google Scholar 

  12. Dupuis LL, Lingertat-Walsh K, Walker SE. Stability of an extemporaneous oral liquid aprepitant formulation. Support Care Cancer. 2009;17(6):701–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Pauline Belin (Université Claude Bernard, Lyon, France) for excellent assistance in analyzing the majority of the data.

Funding

None.

Conflicts of interest

There are no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tiene G. M. Bauters.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bauters, T.G.M., Verlooy, J., Robays, H. et al. Emesis control by aprepitant in children and adolescents with chemotherapy. Int J Clin Pharm 35, 1021–1024 (2013). https://doi.org/10.1007/s11096-013-9842-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-013-9842-4

Keywords

Navigation