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LETTERS TO EDITOR
Year : 2021  |  Volume : 4  |  Issue : 1  |  Page : 141-142

Aprepitant for patients with head-and-neck cancer receiving once-a-week cisplatin with radiation: Is it required?


Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

Date of Submission18-Jan-2021
Date of Decision31-Jan-2021
Date of Acceptance04-Feb-2021
Date of Web Publication26-Mar-2021

Correspondence Address:
Kumar Prabhash
Department of Medical Oncology, Tata Memorial Hospital, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_9_21

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How to cite this article:
Noronha V, D'souza H, Choudhary AK, Patil VM, Singh GK, Joshi A, Menon N, Prabhash K. Aprepitant for patients with head-and-neck cancer receiving once-a-week cisplatin with radiation: Is it required?. Cancer Res Stat Treat 2021;4:141-2

How to cite this URL:
Noronha V, D'souza H, Choudhary AK, Patil VM, Singh GK, Joshi A, Menon N, Prabhash K. Aprepitant for patients with head-and-neck cancer receiving once-a-week cisplatin with radiation: Is it required?. Cancer Res Stat Treat [serial online] 2021 [cited 2021 Jun 24];4:141-2. Available from: https://www.crstonline.com/text.asp?2021/4/1/141/312123



Concurrent chemoradiation (CRT) is an important treatment modality in patients with head-and-neck squamous cell carcinomas.[1] Cisplatin is a commonly used radiosensitizer in this setting.[2] The emetogenic potential of cisplatin in a once-a-week regimen at doses below 50 mg/m2 is lower than that with the 100 mg/m2 once-in-3-weeks regimen.[3],[4] Aprepitant is a necessary antiemetic administered usually in once-in-3-weeks regimens.[5] However, there are limited data on the utility of aprepitant with a once-a-week cisplatin regimen.[6]

Patil et al. conducted a Phase III randomized trial on 536 patients with head-and-neck cancers, comparing radical CRT with once-a-week cisplatin, with or without nimotuzumab.[7] We retrospectively studied the impact of aprepitant on nausea and vomiting in the patients enrolled in this trial. Of the 536 patients enrolled in the trial, data related to the adverse events of nausea and vomiting were available for 524 patients, and data on the use of aprepitant were available for 521 patients.

Nausea and vomiting of any grade were observed in 251 (47.9%) and 155 (29.6%) patients, respectively. Nausea and vomiting of grade 3 and above were seen in 6 (1.1%) and 7 (1.3%) patients, respectively. Nausea of any grade was observed in 112 (42.3%) of 265 patients who received aprepitant versus 137 (53.5%) of 265 patients who did not receive aprepitant (P = 0.011). Likewise, vomiting of any grade was observed in 71 (26.8%) of 265 patients who received aprepitant versus 84 (31.7%) of 265 patients who did not receive aprepitant (P = 0.252). The adjusted odds ratios for the use of aprepitant for antiemetic prophylaxis in the prevention of nausea and vomiting of any grade were 1.585 (1.116–2.249; P = 0.010) and 1.328 (0.904–1.951; P = 0.149), respectively. There was no difference in the rates of grade 3 or above nausea (P = 0.686) or vomiting (P = 0.278) between the two cohorts. In conclusion, the use of aprepitant with once-a-week cisplatin led to a significant decrease in nausea of any grade. It is important to confirm these findings in a prospective randomized setting.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Pfister DG, Spencer S, Brizel DM, Burtness B, Busse PM, Caudell JJ, et al. Head and Neck Cancers, Version 2.2014. Clinical practice guidelines in oncology. J Natl Compr Canc Netw 2014;12:1454-87.  Back to cited text no. 1
    
2.
Goyal G, Patil VM, Noronha V, Joshi A, Khaddar S, Kakkar S, et al. Once-a-week versus once-every-3-weeks cisplatin in patients receiving chemoradiation for locally advanced head-and-neck cancer: A survey of practice in India. Cancer Res Stat Treat 2018;1:63-7.  Back to cited text no. 2
  [Full text]  
3.
Schnell FM. Chemotherapy-induced nausea and vomiting: The importance of acute antiemetic control. Oncologist 2003;8:187-98.  Back to cited text no. 3
    
4.
Noronha V, Joshi A, Patil VM, Agarwal J, Ghosh-Laskar S, Budrukkar A, et al. Once-a-week versus once-every-3-weeks cisplatin chemoradiation for locally advanced head and neck cancer: A phase III randomized noninferiority trial. J Clin Oncol 2018;36:1064-72.  Back to cited text no. 4
    
5.
Aapro M, Carides A, Rapoport BL, Schmoll HJ, Zhang L, Warr D. Aprepitant and fosaprepitant: A 10-year review of efficacy and safety. Oncologist 2015;20:450-8.  Back to cited text no. 5
    
6.
Karpe A, Patil VM, Joshi A, Noronha V, Gupta S, Ramaswamy A, et al. Weekly cisplatin (30-40 mg/m2) as radiosensitizer: Is it high or moderate emetic agent? Indian J Cancer 2016;53:454-6.  Back to cited text no. 6
[PUBMED]  [Full text]  
7.
Patil VM, Noronha V, Joshi A, Agarwal J, Ghosh-Laskar S, Budrukkar A, et al. A randomized phase 3 trial comparing nimotuzumab plus cisplatin chemoradiotherapy versus cisplatin chemoradiotherapy alone in locally advanced head and neck cancer. Cancer 2019;125:3184-97.  Back to cited text no. 7
    




 

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