Prevention of cisplatin-induced acute and delayed emesis by the selective neurokinin-1 antagonists, L-758,298 and MK-869.
Abstract | BACKGROUND: METHODS: This was a multicenter, double-blind, randomized, active agent-controlled study of 177 cisplatin-naïve patients with malignant disease. On Day 1, MK-869 was given intravenously as its water-soluble prodrug, L-758,298. Patients were randomized to one of three groups as follows. Group I received L-758,298 100 mg intravenously (i.v.), then dexamethasone 20 mg i.v., and cisplatin >or= 70 mg/m(2) on Day 1 followed by 300 mg MK-869 ( tablet) orally on Days 2-5; Group II received L-758,298 100 mg i.v., then dexamethasone 20 mg i.v., and cisplatin >or= 70 mg/m(2) on Day 1 followed by placebo on Days 2-5; and Group III received ondansetron 32 mg i.v., then dexamethasone 20 mg i.v., and cisplatin >or= 70 mg/m(2) on Day 1 followed by placebo on Days 2-5. Emesis was recorded over Days 1-5 in a diary. Nausea was assessed every 24 hours by visual analog scale. Additional medication was available for emesis or nausea at any time. The primary efficacy parameters of interest were the proportion of patients without emesis and the proportion without emesis or rescue therapy on Day 1 (acute phase) and on Days 2-5 (delayed phase). RESULTS: No serious adverse events were attributed to L-758,298 or MK-869. On Day 1, the proportions of patients with no emesis and no use of rescue medication were 44% of patients in Group I, 36% of patients in Group II, 40% of patients in Groups I and II combined, and 83% of patients in Group III (P < 0.001 for Group III vs. the combined Groups I and II). The proportions of patients with no emesis and no use of rescue medication on Days 2-5 were 59% of patients in Group I, 46% of patients in Group II, and 38% of patients in Group III (P < 0.05 for Group I vs. Group III). The proportions of patients who were without emesis on Day 1 were 49% of patients in Group I, 47% of patients in Group II, and 84% of patients in Group III (P < 0.01 for Group I or II vs. Group III). On Days 2-5, however, the proportions of patients who were without emesis on Days 2-5 were 65% of patients in Group I, 61% of patients in Group II, and 41% of patients in Group III (P < 0.05 for Group I or II vs. Group III). Nausea scores in the acute phase were lower for Group III than for Group I, Group II, or Groups I and II combined (P < 0.05), although there was no significant difference among groups either for the delayed phase or overall for Days 1-5. CONCLUSIONS:
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Authors | Simon Van Belle, Michael R Lichinitser, Rudolph M Navari, August M Garin, Marc L A Decramer, Alain Riviere, Myo Thant, Elmer Brestan, Binh Bui, Krista Eldridge, Marina De Smet, Nicole Michiels, Rick R Reinhardt, Alexandra D Carides, Judith K Evans, Barry J Gertz |
Journal | Cancer
(Cancer)
Vol. 94
Issue 11
Pg. 3032-41
(Jun 01 2002)
ISSN: 0008-543X [Print] United States |
PMID | 12115394
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | (c) 2002 American Cancer Society. |
Chemical References |
- Antiemetics
- Antineoplastic Agents
- L 758298
- Morpholines
- Neurokinin-1 Receptor Antagonists
- Aprepitant
- Ondansetron
- Dexamethasone
- Cisplatin
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Topics |
- Adolescent
- Adult
- Aged
- Antiemetics
(therapeutic use)
- Antineoplastic Agents
(adverse effects, therapeutic use)
- Aprepitant
- Cisplatin
(adverse effects, therapeutic use)
- Dexamethasone
(administration & dosage, pharmacology)
- Double-Blind Method
- Drug Therapy, Combination
- Female
- Humans
- Male
- Middle Aged
- Morpholines
(therapeutic use)
- Neoplasms
(drug therapy)
- Neurokinin-1 Receptor Antagonists
- Ondansetron
(therapeutic use)
- Vomiting
(chemically induced, prevention & control)
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