Efficacy and Safety of an Increased-dose of Dexamethasone in Patients Receiving Fosaprepitant Chemotherapy in Japan

Background: Antiemetic triplet therapy including dexamethasone (DEX) is widely used for patients receivinghighly emetogenic chemotherapy (HEC). In Japan, the appropriate dose of DEX has not been established for thiscombination. Materials and
Methods: To assess the efficacy and safety of increased-dose DEX, we retrospectivelyexamined patients receiving HEC with antiemetic triplet therapy.
Results: Twenty-four patients (fosaprepitantgroup) were given an increased-dose of DEX (average total dose: 45.8mg), fosaprepitant, and 5-HT3 antagonist.A lower-dose of DEX (33.6mg), oral aprepitant, and 5-HT3 antagonist were administered to the other 48 patients(aprepitant group). The vomiting control rates in the fosaprepitant and aprepitant groups were 100% and 85.4%in the acute phase, and were 75.0% and 64.6% in the delayed phase. The incidences of toxicity were similarcomparing the two groups.
Conclusions: Triplet therapy using an increased-dose of DEX is suggested to be safeand effective for patients receiving HEC.