No Difference in Aprepitant vs Fosaprepitant in CINV

The following article features coverage from the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference in Anaheim, California. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Aprepitant and fosaprepitant have similar efficacy and safety profiles for the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV), according to a poster presented at the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference.¹

Current guidelines recommend an NK₁ receptor antagonist, a serotonin (5-HT3) receptor antagonist, and dexamethasone for the prevention and treatment of CINV among patients taking highly or moderately emetogenic chemotherapy. The guidelines do not indicate a preference between the NK₁ receptor antagonists, aprepitant or fosaprepitant. The aim of this study was to determine the comparative efficacy of these agents.

This retrospective cohort study of 41 patients included patients with various cancer types receiving chemotherapy at the University of New Mexico Comprehensive Cancer Center during 2015.

Treatment with aprepitant or fosaprepitant resulted in similar outcomes, with no significant difference in complete response (43.9% vs 41.5%), emesis (14.6% vs 17.1%), nausea (53.7% vs 58.8%), or need for rescue medication (56.1% vs 58.5%).

Aprepitant use required significantly less chair time (214.66 min) compared with fosaprepitant (233.49 min; P < .001).

The rate of adverse effects including constipation, fatigue, diarrhea, anxiety, headache, dizziness, xerostomia, and cough, were similar between the studied groups.

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The results of this study indicate that there is no difference in efficacy or safety between aprepitant and fosaprepitant, though the study was limited by its small sample size.

Read more of Cancer Therapy Advisor‘s coverage of the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference by visiting the conference page.

Reference

1. Case B, Anselmo L, Marshik P, Sanchez L. Aprepitant versus fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting. Poster presented at: 13^th Hematology/Oncology Pharmacy Association Annual Conference; March 29-April 1, 2017; Anaheim, CA.