Table 5.
Level 2 evidence of patient satisfaction with aprepitant in the prevention of CINV in double-blind, mulicenter, parallel-group RCTs
| Chemotherapy regimen | Antiemetic treatment |
Patient satisfaction/QOL rating |
Reference | ||
|---|---|---|---|---|---|
| Acute phase | Delayed phase | Overall | |||
| Highly emetogenic chemotherapy | |||||
| Cis-based ≥70 mg/m2, 1 cycle | Day 1: Gra 10 mcg/kg + Dex 20 mg + Ap 400 mg Day 2–5: Ap 300 mg (n=54) |
100a | NR | 100a (P=0.001) | Navari et al. 1999 |
| Day 1: Gra 10 mcg/kg + Dex 20 mg + Ap 400 mg Day 2–5: Pla (n=54) |
NR | 98a (P=0.03) | |||
| Day 1: Gra 10 mcg/kg + Dex 20 mg + Pla Day 2–5: Pla (n=51) |
100a | NR | 82a | ||
| Cis-based ≥70 mg/m2, 1 cycle | Day −1: Pla Day 1: Gra 10 mcg/kg + Dex 20 mg + Pla Day 2–5: Pla (n=90) |
94a | NR | 92a | Campos et al. 2001 |
| Day −1: Pla Day 1: Gra 10 mcg/kg + Dex 20 mg + Ap 400 mg Day 2–5: Ap 300 mg (n=86) |
98a | NR | 95a | ||
| Day −1: Ap 400 mg Day 1: Dex 20 mg + Ap 400 mg + Pla Day 2–5: Ap 300 mg (n=89) |
96a | NR | 96a | ||
| Day −1: Pla Day 1: Dex 20 mg + Ap 400 mg + Pla Day 2–5: Ap 300 mg (n=86) |
96a | NR | 98a | ||
| Cis-based ≥70 mg/m2, 1 cycle | Day 1: L-758,298 100 mg + Dex 20 mg Day 2–5: Ap 300 mg (n=61) |
91a | 92a | NR | Van Belle et al. 2002 |
| Day 1: L-758,298 100 mg + Dex 20 mg Day 2–5: Pla (n=58) |
88a | NR | |||
| Day 1: Ond 32 mg + Dex 20 mg Day 2–5: Pla (n=58) |
99a (P<0.005 vs other two groups combined) | 96a | NR | ||
| Cis-based ≥70 mg/m2, 1 cycle | Day 1: Ap 125 mg + Ond 32 mg + Dex 12 mg Day 2–3: Ap 80 mg + Dex 8 mg Day 4: Dex 8 mg (n=260) |
NR | NR | 74% minimal/no impactb | Hesketh et al. 2003 |
| Day 1: Ond 32 mg + Dex 20 mg + Pla Day 2–4: Dex 8 mg bid + Pla (n=261) |
NR | NR | 64.3% minimal/no impactb | ||
| Cis-based ≥70 mg/m2, 1 cycle | Day 1: Ap 125 mg + Ond 32 mg + Dex 12 mg Day 2–3: Ap 80 mg + Dex 8 mg Day 4: Dex 8 mg (n=283) |
NR | NR | 74.7% minimal/no impactb | Poli-Bigelli et al. 2003 |
| Day 1: Ond 32 mg + Dex 20 mg + Pla Day 2–4: Dex 8 mg bid + Pla (n=286) |
NR | NR | 63.5% minimal/no impactb | ||
| Cis-based ≥70 mg/m2, 1 cycle | Day 1: Ap 125 mg + Ond 32 mg + Dex 12 mg Day 2–3: Ap 80 mg + Dex 8 mg Day 4: Dex 8 mg (n=547) |
NR | NR | 74% minimal/no impactb (P<0.01 vs standard therapy) | Warr et al. 2005ac |
| Day 1: Ond 32 mg + Dex 20 mg + Pla Day 2–4: Dex 8 mg bid + Pla (n=552) |
NR | NR | 64% minimal/no impactb | ||
| Moderately emetogenic chemotherapy | |||||
| Cyc 750–1500 mg/m2 alone or Cyc 500–1500 mg/m2 + Dox ≤60 mg/m2 or Epi ≤100 mg/m2, 4 cycles | Day 1: Ap 125 mg + Ond 8 mg + Dex 12 mg before chemo and Ond 8 mg after 8 h Day 2–3: Ap 80 mg (n=438) |
NR | NR | 63.5% minimal/no impactb (P=0.019 vs standard therapy) | Warr et al. 2005b |
| Day 1: Ond 8 mg + Dex 20 mg + Pla before chemo and Ond 8 mg after 8 h Day 2–3: Ond 8 mg bid (n=428) |
NR | NR | 55.6% minimal/no impactb | ||
a
Median global satisfaction VAS ratings (0=not at all satisfied; 100=completely satisfied);
b
Functional Living Index Emesis (FLIE) questionnaire response;
c
Pooled analysis of Hesketh et al. 2003 and Poli-Bigelli et al. 2003.
Ap, aprepitant; bid, twice daily; CINV, chemotherapy-induced nausea and vomiting; Cis, cisplatin; Cyc, cyclophosphamide; Dex, dexamethasone; Dox, doxorubicin; Epi, epirubicin; Gra, granisetron; h, hour; NR, not reported; Ond, ondansetron; Pla, placebo; QOL, quality of life; RCT, randomized controlled trial; VAS, visual analog scale.