Augmentation of Antiemetic Drug Regimen Explored

Adding casopitant may reduce chemotherapy-induced vomiting and rescue drug use
By A. Agrawal, PhD
HealthDay Reporter

TUESDAY, Oct. 6 (HealthDay News) -- The addition of casopitant, a neurokinin (NK)-1 receptor antagonist, to an antiemetic regimen of dexamethasone and ondansetron reduced vomiting and use of rescue medications in breast cancer patients undergoing their first cycle of chemotherapy, according to a study published online Oct. 5 in the Journal of Clinical Oncology.

As part of a phase III trial, Jorn Herrstedt, M.D., of Herlev Hospital in Copenhagen, Denmark, and colleagues randomly assigned 1,933 breast cancer patients who were receiving anthracycline- and cyclophosphamide-based chemotherapy to placebo, a single oral dose of casopitant, three-day oral casopitant, or three-day intravenous/oral casopitant. All patients also received dexamethasone and ondansetron.

The researchers found that a greater proportion of patients in all three casopitant treatment arms achieved no vomiting/retching or rescue medication use in the first 120 hours after chemotherapy initiation as compared to placebo. However, the proportion of patients with nausea or significant nausea was similar across all arms of the study.

"This is the first phase III trial to demonstrate that a single dose of an NK-1 receptor antagonist provides superior prevention of chemotherapy induced nausea and vomiting for five days in patients receiving moderately emetogenic chemotherapy along with standard two-drug antiemetic treatment," Herrstedt and colleagues conclude.

Several authors are employees of GlaxoSmithKline, and other authors reported financial and consulting relationships with pharmaceutical companies.

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