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Published in: Supportive Care in Cancer 1/2017

Open Access 01-01-2017 | Original Article

Rolapitant improves quality of life of patients receiving highly or moderately emetogenic chemotherapy

Authors: Martin Chasen, Laszlo Urban, Ian Schnadig, Bernardo Rapoport, Dan Powers, Sujata Arora, Rudolph Navari, Lee Schwartzberg, Cesare Gridelli

Published in: Supportive Care in Cancer | Issue 1/2017

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Abstract

Purpose

Addition of rolapitant to standard antiemetic therapy improved protection against chemotherapy-induced nausea and vomiting (CINV) in phase 3 trials of patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC). Here, we assessed the impact of CINV on the daily lives of patients receiving HEC or MEC using the Functional Living Index-Emesis (FLIE).

Methods

In three double-blind phase 3 studies, patients receiving HEC or MEC were randomized 1:1 to receive oral rolapitant 180 mg or placebo prior to chemotherapy plus 5-hydroxytryptamine type 3 receptor antagonist and dexamethasone therapy. Patients completed the FLIE questionnaire on day 6 of cycle 1. Endpoints included FLIE total score, nausea and vomiting domain scores, and the proportion of patients with no impact on daily life (total score >108 [range 18–126]). We performed a prespecified analysis of the MEC/anthracycline-cyclophosphamide (AC) study and a post hoc analysis of two pooled cisplatin-based HEC studies.

Results

In the pooled HEC studies, rolapitant significantly improved the FLIE total score (114.5 vs 109.3, p < 0.001), nausea score (55.3 vs 53.5, p < 0.05), and vomiting score (59.2 vs 55.8, p < 0.001) versus control; similar results were observed in the MEC/AC study for FLIE total score (112.7 vs 108.6, p < 0.001), nausea score (54.1 vs 52.3, p < 0.05), and vomiting score (58.6 vs 56.3, p < 0.001). A higher proportion of patients reported no impact on daily life with rolapitant than with control in the MEC/AC study (73.2 vs 67.4, p = 0.027).

Conclusions

Compared with control, rolapitant improved quality of life in patients receiving HEC or MEC.
Literature
1.
go back to reference Bloechl-Daum B, Deuson RR, Mavros P, Hansen M, Herrstedt J (2006) Delayed nausea and vomiting continue to reduce patients’ quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol 24:4472–4478CrossRefPubMed Bloechl-Daum B, Deuson RR, Mavros P, Hansen M, Herrstedt J (2006) Delayed nausea and vomiting continue to reduce patients’ quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol 24:4472–4478CrossRefPubMed
2.
go back to reference Ballatori E, Roila F, Ruggeri B, et al. (2007) The impact of chemotherapy-induced nausea and vomiting on health-related quality of life. Support Care Cancer 15:179–185CrossRefPubMed Ballatori E, Roila F, Ruggeri B, et al. (2007) The impact of chemotherapy-induced nausea and vomiting on health-related quality of life. Support Care Cancer 15:179–185CrossRefPubMed
3.
go back to reference Cohen L, de Moor CA, Eisenberg P, Ming EE, Hu H (2007) Chemotherapy-induced nausea and vomiting: incidence and impact on patient quality of life at community oncology settings. Support Care Cancer 15:497–503CrossRefPubMed Cohen L, de Moor CA, Eisenberg P, Ming EE, Hu H (2007) Chemotherapy-induced nausea and vomiting: incidence and impact on patient quality of life at community oncology settings. Support Care Cancer 15:497–503CrossRefPubMed
4.
go back to reference NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Antiemesis. Version 2.2015 NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Antiemesis. Version 2.2015
5.
go back to reference Coates A, Abraham S, Kaye SB, et al. (1983) On the receiving end—patient perception of the side-effects of cancer chemotherapy. Eur J Cancer Clin Oncol 19:203–208CrossRefPubMed Coates A, Abraham S, Kaye SB, et al. (1983) On the receiving end—patient perception of the side-effects of cancer chemotherapy. Eur J Cancer Clin Oncol 19:203–208CrossRefPubMed
6.
go back to reference de Boer-Dennert M, de Wit R, Schmitz PI, et al. (1997) Patient perceptions of the side-effects of chemotherapy: the influence of 5HT3 antagonists. Br J Cancer 76:1055–1061CrossRefPubMedPubMedCentral de Boer-Dennert M, de Wit R, Schmitz PI, et al. (1997) Patient perceptions of the side-effects of chemotherapy: the influence of 5HT3 antagonists. Br J Cancer 76:1055–1061CrossRefPubMedPubMedCentral
8.
9.
go back to reference Navari RM (2013) Management of chemotherapy-induced nausea and vomiting: focus on newer agents and new uses for older agents. Drugs 73:249–262CrossRefPubMed Navari RM (2013) Management of chemotherapy-induced nausea and vomiting: focus on newer agents and new uses for older agents. Drugs 73:249–262CrossRefPubMed
10.
go back to reference Hesketh PJ, Grunberg SM, Gralla RJ, et al. (2003) The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin. The Aprepitant Protocol 052 Study Group. J Clin Oncol 21:4112–4119CrossRefPubMed Hesketh PJ, Grunberg SM, Gralla RJ, et al. (2003) The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin. The Aprepitant Protocol 052 Study Group. J Clin Oncol 21:4112–4119CrossRefPubMed
11.
go back to reference Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, et al. (2003) Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo-controlled trial in Latin America. Cancer 97:3090–3098CrossRefPubMed Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, et al. (2003) Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo-controlled trial in Latin America. Cancer 97:3090–3098CrossRefPubMed
12.
go back to reference Warr DG, Hesketh PJ, Gralla RJ, et al. (2005) Efficacy and tolerability of aprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients with breast cancer after moderately emetogenic chemotherapy. J Clin Oncol 23:2822–2830CrossRefPubMed Warr DG, Hesketh PJ, Gralla RJ, et al. (2005) Efficacy and tolerability of aprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients with breast cancer after moderately emetogenic chemotherapy. J Clin Oncol 23:2822–2830CrossRefPubMed
13.
go back to reference Rapoport BL, Jordan K, Boice JA, et al. (2010) Aprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with a broad range of moderately emetogenic chemotherapies and tumor types: a randomized, double-blind study. Support Care Cancer 18:423–431CrossRefPubMed Rapoport BL, Jordan K, Boice JA, et al. (2010) Aprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with a broad range of moderately emetogenic chemotherapies and tumor types: a randomized, double-blind study. Support Care Cancer 18:423–431CrossRefPubMed
14.
go back to reference Escobar Y, Cajaraville G, Virizuela JA, et al. (2015) Incidence of chemotherapy-induced nausea and vomiting with moderately emetogenic chemotherapy: ADVICE (Actual Data of Vomiting Incidence by Chemotherapy Evaluation) study. Support Care Cancer 23:2833–2840CrossRefPubMedPubMedCentral Escobar Y, Cajaraville G, Virizuela JA, et al. (2015) Incidence of chemotherapy-induced nausea and vomiting with moderately emetogenic chemotherapy: ADVICE (Actual Data of Vomiting Incidence by Chemotherapy Evaluation) study. Support Care Cancer 23:2833–2840CrossRefPubMedPubMedCentral
15.
go back to reference Majem M, Moreno ME, Calvo N, et al. (2011) Perception of healthcare providers versus patient reported incidence of chemotherapy-induced nausea and vomiting after the addition of NK-1 receptor antagonists. Support Care Cancer 19:1983–1990CrossRefPubMed Majem M, Moreno ME, Calvo N, et al. (2011) Perception of healthcare providers versus patient reported incidence of chemotherapy-induced nausea and vomiting after the addition of NK-1 receptor antagonists. Support Care Cancer 19:1983–1990CrossRefPubMed
16.
go back to reference Lindley CM, Hirsch JD, O'Neill CV, Transau MC, Gilbert CS, Osterhaus JT (1992) Quality of life consequences of chemotherapy-induced emesis. Qual Life Res 1:331–340CrossRefPubMed Lindley CM, Hirsch JD, O'Neill CV, Transau MC, Gilbert CS, Osterhaus JT (1992) Quality of life consequences of chemotherapy-induced emesis. Qual Life Res 1:331–340CrossRefPubMed
17.
go back to reference Martin AR, Pearson JD, Cai B, Elmer M, Horgan K, Lindley C (2003) Assessing the impact of chemotherapy-induced nausea and vomiting on patients’ daily lives: a modified version of the Functional Living Index-Emesis (FLIE) with 5-day recall. Support Care Cancer 11:522–527CrossRefPubMed Martin AR, Pearson JD, Cai B, Elmer M, Horgan K, Lindley C (2003) Assessing the impact of chemotherapy-induced nausea and vomiting on patients’ daily lives: a modified version of the Functional Living Index-Emesis (FLIE) with 5-day recall. Support Care Cancer 11:522–527CrossRefPubMed
18.
go back to reference Martin AR, Carides AD, Pearson JD, et al. (2003) Functional relevance of antiemetic control. Experience using the FLIE questionnaire in a randomised study of the NK-1 antagonist aprepitant. Eur J Cancer 39:1395–1401CrossRefPubMed Martin AR, Carides AD, Pearson JD, et al. (2003) Functional relevance of antiemetic control. Experience using the FLIE questionnaire in a randomised study of the NK-1 antagonist aprepitant. Eur J Cancer 39:1395–1401CrossRefPubMed
19.
go back to reference VARUBI® (rolapitant) tablets, for oral use [prescribing information] (2015) VARUBI® (rolapitant) tablets, for oral use [prescribing information] (2015)
20.
go back to reference Rapoport BL, Chasen MR, Gridelli C, et al. (2015) Safety and efficacy of rolapitant for prevention of chemotherapy-induced nausea and vomiting after administration of cisplatin-based highly emetogenic chemotherapy in patients with cancer: two randomised, active-controlled, double-blind, phase 3 trials. Lancet Oncol 16:1079–1089CrossRefPubMed Rapoport BL, Chasen MR, Gridelli C, et al. (2015) Safety and efficacy of rolapitant for prevention of chemotherapy-induced nausea and vomiting after administration of cisplatin-based highly emetogenic chemotherapy in patients with cancer: two randomised, active-controlled, double-blind, phase 3 trials. Lancet Oncol 16:1079–1089CrossRefPubMed
21.
go back to reference Schwartzberg LS, Modiano MR, Rapoport BL, et al. (2015) Safety and efficacy of rolapitant for prevention of chemotherapy-induced nausea and vomiting after administration of moderately emetogenic chemotherapy or anthracycline and cyclophosphamide regimens in patients with cancer: a randomised, active-controlled, double-blind, phase 3 trial. Lancet Oncol 16:1071–1078CrossRefPubMed Schwartzberg LS, Modiano MR, Rapoport BL, et al. (2015) Safety and efficacy of rolapitant for prevention of chemotherapy-induced nausea and vomiting after administration of moderately emetogenic chemotherapy or anthracycline and cyclophosphamide regimens in patients with cancer: a randomised, active-controlled, double-blind, phase 3 trial. Lancet Oncol 16:1071–1078CrossRefPubMed
22.
go back to reference Aapro M, Rugo H, Rossi G, et al. (2014) A randomized phase III study evaluating the efficacy and safety of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy. Ann Oncol 25:1328–1333CrossRefPubMedPubMedCentral Aapro M, Rugo H, Rossi G, et al. (2014) A randomized phase III study evaluating the efficacy and safety of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy. Ann Oncol 25:1328–1333CrossRefPubMedPubMedCentral
23.
go back to reference Yeo W, Mo FK, Suen JJ, et al. (2009) A randomized study of aprepitant, ondansetron and dexamethasone for chemotherapy-induced nausea and vomiting in Chinese breast cancer patients receiving moderately emetogenic chemotherapy. Breast Cancer Res Treat 113:529–535CrossRefPubMed Yeo W, Mo FK, Suen JJ, et al. (2009) A randomized study of aprepitant, ondansetron and dexamethasone for chemotherapy-induced nausea and vomiting in Chinese breast cancer patients receiving moderately emetogenic chemotherapy. Breast Cancer Res Treat 113:529–535CrossRefPubMed
24.
go back to reference Poma A, Christensen J, Davis J, Kansra V, Martell RE, Hedley ML (2014) Phase 1 positron emission tomography (PET) study of the receptor occupancy of rolapitant, a novel NK-1 receptor antagonist. J Clin Oncol 32:e20690 Poma A, Christensen J, Davis J, Kansra V, Martell RE, Hedley ML (2014) Phase 1 positron emission tomography (PET) study of the receptor occupancy of rolapitant, a novel NK-1 receptor antagonist. J Clin Oncol 32:e20690
25.
go back to reference Russo S, Cinausero M, Gerratana L, et al. (2014) Factors affecting patient’s perception of anticancer treatments side-effects: an observational study. Expert Opin Drug Saf 13:139–150CrossRefPubMed Russo S, Cinausero M, Gerratana L, et al. (2014) Factors affecting patient’s perception of anticancer treatments side-effects: an observational study. Expert Opin Drug Saf 13:139–150CrossRefPubMed
26.
go back to reference Davidson W, Teleni L, Muller J, et al. (2012) Malnutrition and chemotherapy-induced nausea and vomiting: implications for practice. Oncol Nurs Forum 39:E340–E345CrossRefPubMed Davidson W, Teleni L, Muller J, et al. (2012) Malnutrition and chemotherapy-induced nausea and vomiting: implications for practice. Oncol Nurs Forum 39:E340–E345CrossRefPubMed
27.
go back to reference Isenring E, Bauer J, Capra S (2003) The scored patient-generated subjective global assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 57:305–309CrossRefPubMed Isenring E, Bauer J, Capra S (2003) The scored patient-generated subjective global assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 57:305–309CrossRefPubMed
Metadata
Title
Rolapitant improves quality of life of patients receiving highly or moderately emetogenic chemotherapy
Authors
Martin Chasen
Laszlo Urban
Ian Schnadig
Bernardo Rapoport
Dan Powers
Sujata Arora
Rudolph Navari
Lee Schwartzberg
Cesare Gridelli
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 1/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3388-7

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