Abstract
No antiemetic therapies of aprepitant have been established for continuous administration of anticancer drugs across multiple days. We investigated the efficacy of using aprepitant for 3 days from Day 2 of 5-day ifosfamide administration in patients with osteosarcoma. Between December 1, 2008 and November 30, 2010, patients with osteosarcoma receiving ifosfamide therapy were allocated to either a control group or an aprepitant group. We retrospectively investigated the proportion of patients with no emetic episodes, the proportion of patients with complete response (defined as no emetic episodes and no use of rescue medication) and adverse events. We divided the proportion of patients with no emetic episodes and the proportion of patients with complete response into three periods (Days 1-5, Days 6-10 and Days 1-10), then evaluated the results. The proportion of patients with no emetic episodes was significantly higher in the aprepitant group than in the control group (during Days 1-5, 100% vs. 58.8%, p=0.012, during Days 1-10, 91.6% vs. 41.1%, p=0.007, respectively). The proportion with complete response tended to be higher in the aprepitant group, but no significant difference between groups was identified. A tendency toward decreased adverse events was also seen in the aprepitant group compared to the control group. These results suggest that administration of aprepitant for 3 days from Day 2 of anticancer drug administration can prevent emetic episodes with ifosfamide therapy. Establishment of appropriate antiemetic therapies may thus facilitate continuous administration of anticancer drugs.
