Efficacy of Aprepitant in Patients with Advanced or Recurrent Lung Cancer Receiving Moderately Emetogenic Chemotherapy

Aims and Background: To evaluate the efficacy of a combination of aprepitant and conventional antiemetictherapy in patients with advanced or recurrent lung cancer receiving moderately emetogenic chemotherapy(MEC).
Methods: Patients with advanced or recurrent lung cancer who were treated with MEC regimens atthe Department of Respiratory Medicine, Fukuoka University Hospital, were included and classified into thefollowing groups: control group (treatment: 5-HT3 receptor antagonists + dexamethasone) and aprepitantgroup (treatment: 5-HT3 receptor antagonists + dexamethasone + aprepitant). The presence or absence ofchemotherapy-induced nausea and vomiting (CINV) was evaluated according to the Common TerminologyCriteria for Adverse Events (CTCAE) v4.0; patients with grade 1 or above were considered positive for CINV.Food intake per day, completion of planned chemotherapy, and progression-free survival (PFS) achieved bychemotherapy were investigated.
Results: The complete suppression rate of nausea in the aprepitant group wassignificantly higher than that in the control group (p = 0.0043). Throughout the study, the food intake in theaprepitant group was greater than that in the control group, with the rate being significantly higher, in particular,on day 5 (p = 0.003). The completion rate of planned chemotherapy was also higher in the aprepitant group(p = 0.042). PFS did not differ significantly, but tended to be improved in the aprepitant group.
Conclusions:The aprepitant group showed significantly higher complete suppression of nausea, food intake on day 5, andcompletion of planned chemotherapy than the control group.