Patients with cervical cancer who receive fosaprepitant in addition to palonosetron and dexamethasone may be less likely to experience emesis and nausea compared to those receiving palonosetron and dexamethasone alone, according to a study published in The Lancet Oncology.1
Researchers led by Christina Ruhlmann, PhD, of the Odense University Hospital in Denmark conducted a multinational, randomized, double-blind, placebo-controlled phase 3 trial of 234 women with cervical cancer who were scheduled to receive fractionated radiotherapy and weekly cisplatin for 5 weeks.
These patients were randomly assigned to receive either single doses of fosaprepitant intravenously or placebo in combination with palonosetron intravenously and dexamethasone orally before cisplatin administration.
The percentage of patients on fosaprepitant who sustained no emesis at 5 weeks was found to be 65.7% compared to 48.7% for those on placebo, with a significantly lower cumulative risk of emesis in the fosaprepitant group as well.
Treatments were found to be generally well-tolerated with few grade 3 adverse events, the most common being diarrhea, and none of which were related to the study treatment. There was only one report of a grade 4 adverse event of neutropenia in the fosaprepitant group.
“To our knowledge, this is the first study to investigate safety and efficacy of a NK-1 receptor antagonist during 5 weeks of radiotherapy and concomitant weekly cisplatin,” the authors noted. “Further investigations in other radiotherapy settings are warranted.”
- Ruhlmann CH, Christensen TB, Dohn LH, et al. Efficacy and safety of fosaprepitant for the prevention of nausea and emesis during 5 weeks of chemoradiotherapy for cervical cancer (the GAND-emesis study): a multinational, randomised, placebo-controlled, double-blind, phase 3 trial [published online ahead of print March 4, 2016]. Lancet Oncol. doi: 10.1016/S1470-2045(15)00615-4.