Addition of aprepitant prevents chemotherapy-induced vomiting and nausea moderately when 5-Hydroxytryptamine-3 receptor antagonists and dexamethasone failed

Aprepitant is one of the effective antiemetic drugs that usually used for prevention of Capecitabine and oxaliplatin (XELOX) chemotherapy- induced nausea and vomiting (CINV). We aimed to evaluate the effect of aprepitant on the control of CINV when conventional antiemetics failed. Patients with gastric and colon cancer scheduled to receive XELOX regimens were enrolled in this study, initially receiving 5-Hydroxytryptamine-3 (5-HT3) receptor antagonists and dexamethasone as anti-emetics. After patients experienced vomiting of grade >= 2 and required rescue anti-emetic drugs in the first cycle, oral aprepitant was added in second cycle. Acute (day 1) and delayed (days 2-5) CINV and occurrence of adverse reactions were investigated after the start of chemotherapy. Thirty patients (19.7%) were administered aprepitant for rescue project against CINV during the second cycle of chemotherapy. Delayed CINV were 100% during the first cycle but became lower in the second cycle, which revealed significant effectiveness of the addition of aprepitant on the control of delayed CINV when 5-HT3 receptor antagonists and dexamethasone failed. The incidences of acute and delayed nausea and vomiting in the first cycle of chemotherapy were significantly higher than the second cycle added aprepitant as rescue antiemetic (P< 0.05). The incidences of nausea and vomiting were significantly lower after taken the rescue medication aprepitant. Addition of aprepitant to 5-HT3 antagonists and dexamethasone resulted in significantly better prevention of nausea and vomiting than the first cycle for gastric and colon cancer patients receiving XELOX chemotherapy.