A triple
antiemetic therapy combining
aprepitant (APR) with conventional double
antiemetic therapy, including
5-hydroxytryptamine 3 receptor antagonist (5-HT₃-RA) and
dexamethasone (DEX), is recommended for preventing
chemotherapy-induced
nausea and
vomiting induced by a
carboplatin (
CBDCA) regimen. However, consensus on the additive effects of APR for gynecological patients on a combined regimen of
paclitaxel and
CBDCA (TC regimen) has yet to be reached. This retrospective study investigated the
antiemetic effects of
palonosetron and DEX (PD
therapy) and
granisetron and DEX with APR (GDA
therapy) in patients with gynecologic
cancer and who underwent their first TC regimen cycle between April 2017 and March 2020 at the Gunma University Hospital Outpatient
Chemotherapy Center. The results showed that the complete response rate of the 92 patients who underwent PD
therapy (PD group) and the 46 patients who underwent GDA
therapy (GDA group) were both 80.4% (p = 1.000), and the complete control rates of the PD and GDA groups were 78.3% and 80.4%, respectively (p = 0.828), resulting in no significant difference. Furthermore, we observed no significant difference between the PD and GDA groups in the incidence of grade ≥2
nausea,
vomiting, and
anorexia (
nausea: 7.6% vs. 0%, p = 0.095;
vomiting: 4.3% vs. 0%, p = 0.301; and
anorexia: 9.8% vs. 2.2%, p = 0.164). Concerning adverse events, compared to the PD group, the GDA group showed significantly higher incidence of grade ≥2 malaise (7.6% vs. 19.6%, p = 0.039). Given the lack of difference in the
antiemetic effects of PD and GDA
therapies,
antiemetic therapy should be selected carefully for individual patients by accounting for the incidence of adverse reactions and interactions with APR.