Abstract
There have been few reports on efficacy of aprepitant for the prevention of chemotherapy-induced nausea and vomiting in pediatric cancer patients. In this study, we evaluated the efficacy of aprepitant in patients aged 7-16 years. Between June 2011 and June 2012, 9 patients with hematologic malignancy and osteosarcoma who had received highly and moderately emetogenic chemotherapy with methotrexate (≥1000 mg/m2), cytarabine (≥2000 mg/m2), cyclophosphamide (≥200 mg/m2), or ifosfamide (≥800 mg/m2) at Iwate Medical University Hospital were enrolled in this study. We retrospectively analyzed the number of emetic episodes within 7 days from the start of chemotherapy in 7 patients treated with a combination of granisetron and aprepitant (aprepitant group, a total of 21 cycles) and in 8 patients treated with granisetron without aprepitant (control group, a total of 20 cycles).
The rate of complete response (defined as no emetic episodes and no use of rescue medication) was significantly higher in the aprepitant group (71％) than in the control group (15％). The percentage of patients with no emetic episodes during the acute and delayed periods was significantly higher in the aprepitant group than in the control group (acute period, 75％ vs 100％ and delayed period, 15％ vs 76％). No adverse events associated with aprepitant or granisetron were observed. Aprepitant was considered a useful drug, because it showed superior antiemetic effects in children aged 7-16 years. The results of this study could provide important information for the development of antiemetic therapy for pediatric cancer patients undergoing chemotherapy.
