Combination antiemetic therapy with aprepitant/fosaprepitant in patients with colorectal cancer receiving oxaliplatin-based chemotherapy in the SENRI trial: analysis of risk factors for vomiting and nausea

Int J Clin Oncol. 2017 Feb;22(1):88-95. doi: 10.1007/s10147-016-1022-9. Epub 2016 Jul 27.

Abstract

Background: We previously reported in the SENRI trial on the usefulness of aprepitant for the prevention of chemotherapy-induced nausea and vomiting (CINV) in colorectal cancer patients receiving an oxaliplatin-based regimen which is classified as moderately emetogenic cancer chemotherapy. In the present subgroup analysis of the SENRI trial, we assessed the risk factors for CINV in colorectal cancer patients who received oxaliplatin-based chemotherapy.

Methods: Multivariate logistic regression models were used to assess the impact of aprepitant use and patient characteristics on vomiting and nausea. We also assessed the proportion of CINV in patients by gender.

Results: Female gender and aprepitant use were associated with the incidence of vomiting and no significant nausea. Significantly more men achieved no vomiting than women (92.9 vs 84.5 % in men and women, respectively; P = 0.0001). The rate of no nausea, complete response, complete protection, and total control was also higher in men. The rate rescue therapy use was significantly higher in women than men. We compared the rate of CINV between aprepitant and control groups and found a significant difference in male patients who achieved no vomiting and complete protection in the overall phase. In women, the rate of no nausea, no vomiting, and total control was higher in the aprepitant group than in the control group.

Conclusions: Gender and aprepitant use were risk factors for CINV in colorectal patients who received oxaliplatin-based chemotherapy. Aprepitant therapy was more effective for women than for men in the prevention of CINV in colorectal cancer patients receiving an oxaliplatin-based regimen.

Keywords: Aprepitant; CINV; Colorectal cancer; Gender; Oxaliplatin; Risk factors; Subgroup analysis.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antiemetics / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Aprepitant
  • Colorectal Neoplasms / drug therapy*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Morpholines / administration & dosage
  • Morpholines / therapeutic use
  • Nausea / chemically induced*
  • Nausea / prevention & control
  • Organoplatinum Compounds / administration & dosage
  • Organoplatinum Compounds / adverse effects
  • Oxaliplatin
  • Risk Factors
  • Vomiting / chemically induced*
  • Vomiting / prevention & control

Substances

  • Antiemetics
  • Morpholines
  • Organoplatinum Compounds
  • Oxaliplatin
  • Aprepitant
  • fosaprepitant