内容紹介
Information Provided by Pharmacists Regarding the Effective Timing of the Coadministration of First-Generation Serotonin Receptor Antagonists and Dexamethasone for Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Doxorubicin and Cyclophosphamide Chemotherapy for Breast Cancer―The Second Report
Summary
In this report, we highly recommend the coadministration of first-generation serotonin receptor antagonists, dexamethasone, and aprepitant for chemotherapy-associated nausea and vomiting in patients with breast cancer receiving doxorubicin and cyclophosphamide(AC)chemotherapy. Aprepitant has an advantage of high efficacy rates for the treatment of nausea and vomiting; its disadvantages include the high cost and interactions with other drugs. Herein, we report the information provided by pharmacists regarding the effective timing of the coadministration of first-generation serotonin receptor antagonists and dexamethasone for nausea and vomiting in patients receiving AC chemotherapy for breast cancer. The primary end point was the proportion of patients who achieved a complete response(CR; no emesis or use of rescue therapy)in cycle 1 after receiving AC chemotherapy. A total of 46 patients were enrolled in this study between November 2010 and December 2011. The overall rate of CR(0-120 hours)was 85%. The rates of acute(0-24 hours)and delayed(24-120 hours)CR were 85% and 93%, respectively. These findings suggest that the information provided by pharmacists regarding the effective timing of the coadministration of first-generation serotonin receptor antagonists and dexamethasone is effective in patients who cannot be administered with aprepitant.
要旨
乳がんドキソルビシン+シクロホスファミド療法を施行する患者は,第一世代セロトニン受容体拮抗薬(5-HT3a),リン酸デキサメタゾンとアプレピタントが推奨されている。アプレピタントは高い制吐効果があるが,高価であることと相互作用があることが欠点とされている。われわれは乳がんAC療法患者に対して,第一世代5-HT3aとリン酸デキサメタゾンを化学療法の点滴開始時間に合わせて薬剤師が介入した悪心・嘔吐を検証した。主要評価項目は,嘔吐なし,救済処置なしの完全嘔吐抑制(CR)率とした。2010年11月～2011年12月の46名の対象患者のうち,全期間(0～120時間)のCR率は85%,急性期(0～24時間),遅発期(24～120時間)のCR率はそれぞれ85%と93%であった。アプレピタントが服用できない患者に対しての第一世代5-HT3a早期内服が有用な可能性がある。
目次
Summary
In this report, we highly recommend the coadministration of first-generation serotonin receptor antagonists, dexamethasone, and aprepitant for chemotherapy-associated nausea and vomiting in patients with breast cancer receiving doxorubicin and cyclophosphamide(AC)chemotherapy. Aprepitant has an advantage of high efficacy rates for the treatment of nausea and vomiting; its disadvantages include the high cost and interactions with other drugs. Herein, we report the information provided by pharmacists regarding the effective timing of the coadministration of first-generation serotonin receptor antagonists and dexamethasone for nausea and vomiting in patients receiving AC chemotherapy for breast cancer. The primary end point was the proportion of patients who achieved a complete response(CR; no emesis or use of rescue therapy)in cycle 1 after receiving AC chemotherapy. A total of 46 patients were enrolled in this study between November 2010 and December 2011. The overall rate of CR(0-120 hours)was 85%. The rates of acute(0-24 hours)and delayed(24-120 hours)CR were 85% and 93%, respectively. These findings suggest that the information provided by pharmacists regarding the effective timing of the coadministration of first-generation serotonin receptor antagonists and dexamethasone is effective in patients who cannot be administered with aprepitant.
要旨
乳がんドキソルビシン+シクロホスファミド療法を施行する患者は,第一世代セロトニン受容体拮抗薬(5-HT3a),リン酸デキサメタゾンとアプレピタントが推奨されている。アプレピタントは高い制吐効果があるが,高価であることと相互作用があることが欠点とされている。われわれは乳がんAC療法患者に対して,第一世代5-HT3aとリン酸デキサメタゾンを化学療法の点滴開始時間に合わせて薬剤師が介入した悪心・嘔吐を検証した。主要評価項目は,嘔吐なし,救済処置なしの完全嘔吐抑制(CR)率とした。2010年11月～2011年12月の46名の対象患者のうち,全期間(0～120時間)のCR率は85%,急性期(0～24時間),遅発期(24～120時間)のCR率はそれぞれ85%と93%であった。アプレピタントが服用できない患者に対しての第一世代5-HT3a早期内服が有用な可能性がある。