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Controlling Chemotherapy-Induced Nausea and Vomiting with neurokinin-1 Receptor Antagonists in Patients on AC-Based Chemotherapy—Are We There Yet?

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Journal of Cancer Therapy 2012年第1期3卷 90-102页

作者： Kevin Yap Cassandra Leong Alexandre Chan Institute of Digital Healthcare University of Warwick Coventry UK

Chemotherapy-induced nausea and vomiting (CINV) are distressing side effects of chemotherapy. neurokinin-1 receptor antagonists (NK1-RAs) have been incorporated in the contemporary management of CINV. However, clinical studies on NK1-RAs have shown mixed results in reducing CINV risk. Most studies focused on the use of aprepitant (APR) and casopitant (CAS) in breast cancer patients receiving AC-type (doxorubicin and cyclophosphamide) chemotherapy. In this study, we compared the study design and clinical efficacies of these NK1-RAs in reducing CINV risk. Among the selected eight studies, 4 APR Randomized Controlled Trials (RCTs), 2 APR Observational Studies (OSs) and 2 CAS RCTs were identified. Patient-related characteristics such as the proportion of females (60.0% - 100.0%), age (46.5 - 59.5 years), histories of motion (5.6% - 47.0% in NK1-RA arms) and morning sicknesses (14.2% - 45.0% in NK1-RA arms) and types of antiemetic regimens;as well as chemotherapy-related characteristics such as the proportion of patients on AC chemotherapy (15.0% - 100.0%) varied greatly. In terms of efficacies, both APR and CAS improved overall CR and vomiting in majority of the studies. None of the studies, however, demonstrated that NK1-RA could provide adequate nausea control. To conclude, NK1-RAs are effective in improving vomiting and overall CR, but not useful in controlling nausea or attaining CC, the ideal CINV endpoint. A shift in paradigm is needed for future CINV research. As healthcare providers continue to strive for optimum CINV control in their patients, we hope this review can help them make better informed clinical decisions.

关键词： AC Anthracycline-Based Chemotherapy Aprepitant Breast Cancer Casopitant Chemotherapy-Induced Nausea Vomiting neurokinin-1 Receptor Antagonists (NK1-RAs)

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Effect of Antiemetic Agents on Hiccups during Chemotherapy in Patients with Lung Cancer

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Pharmacology & Pharmacy 2018年第4期9卷 124-133页

作者： Shinya Toriumi Kazuharu Nakazawa Masaru Shoji Department of Pharmacy National Hospital Organization East Saitama Hospital Hasuda Saitama Japan Department of Pharmacy National Hospital Organization Kanagawa Hospital Hadano Kanagawa Japan Department of Pharmacodynamics Meiji Pharmaceutical University Kiyose Tokyo Japan

Hiccups commonly occur in patients undergoing chemotherapy for lung cancer and may diminish their motivation for treatment. Therefore, it is important to characterize the hiccups and their risk factors. We examined the medical records of 120 patients with lung cancer during their initial chemotherapy and extracted data on the patients’ profiles and the onset, duration, and severity of their hiccup episodes. We found the incidence of hiccups to be 19.2% among the patients. Hiccups appeared within 3 days of beginning the chemotherapy and disappeared within 4 days. Hiccups hindered sleep in two patients. The characteristics of the hiccups episodes in our study were not different from those of previous studies. We also investigated distinctive features of the patients who developed hiccups. The occurrence of hiccups was associated with gender, age, and the treatment with platinum agents. Antiemetic agents, dexamethasone and neurokinin-1 receptor antagonists, also showed significant effects on hiccup episodes. Although the dose-responsive effect of dexamethasone on hiccups was insignificant and the effects of two neurokinin-1 receptor antagonists, aprepitant and fosaprepitant, on hiccups appeared identical. From these results, we suggest that a high incidence of hiccups may be anticipated with a prophylactic use of antiemetic agents, dexamethasone and neurokinin-1 receptor antagonists.

关键词： Hiccups Dexamethasone neurokinin-1 Receptor Antagonist Antiemetic Agents Lung Cancer

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