抄録
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.