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Rolapitant for the prevention of nausea in patients receiving highly or moderately emetogenic chemotherapy

Most patients receiving highly or moderately emetogenic chemotherapy experience chemotherapy‐induced nausea and vomiting without antiemetic prophylaxis. While neurokinin‐1 receptor antagonists (NK‐1RAs) effectively prevent emesis, their ability to prevent nausea has not been established. We evaluate...

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Autores principales: Navari, Rudolph M., Rapoport, Bernardo L., Powers, Dan, Arora, Sujata, Clark‐Snow, Rebecca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051205/
https://www.ncbi.nlm.nih.gov/pubmed/29790666
http://dx.doi.org/10.1002/cam4.1560
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author Navari, Rudolph M.
Rapoport, Bernardo L.
Powers, Dan
Arora, Sujata
Clark‐Snow, Rebecca
author_facet Navari, Rudolph M.
Rapoport, Bernardo L.
Powers, Dan
Arora, Sujata
Clark‐Snow, Rebecca
author_sort Navari, Rudolph M.
collection PubMed
description Most patients receiving highly or moderately emetogenic chemotherapy experience chemotherapy‐induced nausea and vomiting without antiemetic prophylaxis. While neurokinin‐1 receptor antagonists (NK‐1RAs) effectively prevent emesis, their ability to prevent nausea has not been established. We evaluated the efficacy of the long‐acting NK‐1RA rolapitant in preventing chemotherapy‐induced nausea using post hoc analyses of data from 3 phase 3 trials. Patients were randomized to receive 180 mg oral rolapitant or placebo approximately 1‐2 hours before chemotherapy in combination with a 5‐hydroxytryptamine type 3 RA and dexamethasone. Nausea was assessed by visual analog scale during the acute (≤24 hours), delayed (>24‐120 hours), and overall (0‐120 hours) phases. Post hoc analyses by treatment group (rolapitant vs control) were performed on pooled data within patient subgroups receiving cisplatin‐based, carboplatin‐based, or anthracycline/cyclophosphamide (AC)‐based chemotherapy. In the cisplatin‐based chemotherapy group, significantly more patients receiving rolapitant than control reported no nausea (NN) in the overall (52.3% vs 41.7% [P < .001]; absolute benefit [AB] = 10.6%), delayed (55.7% vs 44.3% [P < .001]; AB = 11.4%), and acute (70.5% vs 64.3% [P = .030]; AB = 6.2%) phases. Similar results were observed in the carboplatin‐based chemotherapy group, with significantly more patients receiving rolapitant than control reporting NN in the overall (62.5% vs 51.2% [P = .023]; AB = 11.3%) and delayed (64.1% vs 53.6% [P = .034]; AB = 10.5%) phases. In the AC‐based chemotherapy group, patients receiving rolapitant or control reported similar NN rates during the overall and delayed phases. Rolapitant effectively prevents nausea during the overall and delayed phases in patients receiving cisplatin‐ or carboplatin‐based chemotherapy.
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spelling pubmed-60512052018-07-20 Rolapitant for the prevention of nausea in patients receiving highly or moderately emetogenic chemotherapy Navari, Rudolph M. Rapoport, Bernardo L. Powers, Dan Arora, Sujata Clark‐Snow, Rebecca Cancer Med Clinical Cancer Research Most patients receiving highly or moderately emetogenic chemotherapy experience chemotherapy‐induced nausea and vomiting without antiemetic prophylaxis. While neurokinin‐1 receptor antagonists (NK‐1RAs) effectively prevent emesis, their ability to prevent nausea has not been established. We evaluated the efficacy of the long‐acting NK‐1RA rolapitant in preventing chemotherapy‐induced nausea using post hoc analyses of data from 3 phase 3 trials. Patients were randomized to receive 180 mg oral rolapitant or placebo approximately 1‐2 hours before chemotherapy in combination with a 5‐hydroxytryptamine type 3 RA and dexamethasone. Nausea was assessed by visual analog scale during the acute (≤24 hours), delayed (>24‐120 hours), and overall (0‐120 hours) phases. Post hoc analyses by treatment group (rolapitant vs control) were performed on pooled data within patient subgroups receiving cisplatin‐based, carboplatin‐based, or anthracycline/cyclophosphamide (AC)‐based chemotherapy. In the cisplatin‐based chemotherapy group, significantly more patients receiving rolapitant than control reported no nausea (NN) in the overall (52.3% vs 41.7% [P < .001]; absolute benefit [AB] = 10.6%), delayed (55.7% vs 44.3% [P < .001]; AB = 11.4%), and acute (70.5% vs 64.3% [P = .030]; AB = 6.2%) phases. Similar results were observed in the carboplatin‐based chemotherapy group, with significantly more patients receiving rolapitant than control reporting NN in the overall (62.5% vs 51.2% [P = .023]; AB = 11.3%) and delayed (64.1% vs 53.6% [P = .034]; AB = 10.5%) phases. In the AC‐based chemotherapy group, patients receiving rolapitant or control reported similar NN rates during the overall and delayed phases. Rolapitant effectively prevents nausea during the overall and delayed phases in patients receiving cisplatin‐ or carboplatin‐based chemotherapy. John Wiley and Sons Inc. 2018-05-23 /pmc/articles/PMC6051205/ /pubmed/29790666 http://dx.doi.org/10.1002/cam4.1560 Text en © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Navari, Rudolph M.
Rapoport, Bernardo L.
Powers, Dan
Arora, Sujata
Clark‐Snow, Rebecca
Rolapitant for the prevention of nausea in patients receiving highly or moderately emetogenic chemotherapy
title Rolapitant for the prevention of nausea in patients receiving highly or moderately emetogenic chemotherapy
title_full Rolapitant for the prevention of nausea in patients receiving highly or moderately emetogenic chemotherapy
title_fullStr Rolapitant for the prevention of nausea in patients receiving highly or moderately emetogenic chemotherapy
title_full_unstemmed Rolapitant for the prevention of nausea in patients receiving highly or moderately emetogenic chemotherapy
title_short Rolapitant for the prevention of nausea in patients receiving highly or moderately emetogenic chemotherapy
title_sort rolapitant for the prevention of nausea in patients receiving highly or moderately emetogenic chemotherapy
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051205/
https://www.ncbi.nlm.nih.gov/pubmed/29790666
http://dx.doi.org/10.1002/cam4.1560
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