Traditionally, at Nagara Medical Center, a high dose of dexamethasone, which had an antiemetic effect, was administered to non-small cell lung cancer patients treated with combination therapy of carboplatin and paclitaxel administered every 3 weeks (3w-CP therapy) to prevent anaphylactic shock. In this study, we evaluated the adequacy of aprepitant (APR), an antiemetic drug, to 3w-CP therapy with regard to its efficacy, safety, and cost effectiveness in patients treated with 3w-CP therapy. We divided subjects into 2 groups: a non-administered group (that did not receive APR) and an administered group (that received APR). With regard to efficacy, nausea that had developed in the delayed phase and anorexia that had developed in the delayed and post-delayed phases were significantly suppressed by the coadministration of APR. With regard to safety, the incidence of hot flashes, hiccups and hyperglycemia were increased significantly by the co-administration of APR. With regard to cost effectiveness, the total drug cost related to antiemetic therapy was increased significantly by the co-administration of APR. These results suggest that the use of APR during 3w-CP therapy would be beneficial to prevent the impairment of quality of life as well as the losing of motivation for continuing chemotherapy by inhibiting the incidence of nausea, vomiting, and anorexia especially in the delayed and the post-delayed phases although APR increased total drug cost and deteriorated several chemotherapy-induced side effects.
