Article re: New anti-nausea drug

[Hebbie]

New drug sharply cuts nausea after chemotherapy

Reuters Health

Posting Date: October 15, 2003

Last Updated: 2003-10-15 12:28:39 -0400 (Reuters Health)

NEW YORK (Reuters) - Nausea and vomiting from chemotherapy can be reduced by nearly 50% when aprepitant is administered with other antiemetics, according to a new study published in the October 15th issue of the Journal of Clinical Oncology.

In an international phase III trial of 520 patients with respiratory cancers, 26% of those who received aprepitant along with ondansetron and dexamethasone, the standard antiemetic treatment, reported nausea and vomiting following chemotherapy.

Patients who took a placebo with the standard drugs reported nausea and vomiting 48% of the time, according to Dr. Paul Hesketh, at the Caritas St. Elizabeth's Medical Center in Boston, and colleagues.

In a separate 164-person phase II study conducted in the Netherlands, the benefits of aprepitant persisted for several rounds of chemotherapy. The findings of Dr. Ronald de Wit of the Rotterdam Cancer Institute and colleagues are also reported in this week's JCO.

Earlier data collected from these studies, and a separate one conducted in South America, formed the basis of the U.S. Food and Drug Administration's approval in March of Merck & Co Inc.'s version of aprepitant called Emend.

Researchers championed aprepitant as the first in a new class of drugs that interfere with nausea and vomiting by blocking NK1 receptors in the brain. Aprepitant works with current treatments that target a different family of receptors.

Aprepitant "really is the first substantial advance that we've had in the prevention of nausea and vomiting related to chemotherapy in almost a decade," said Dr. Hesketh, who led the US-based study.

Dr. Hesketh said the drug helped patients on the day it was given and 4 days afterward. Twenty-five percent of patients who received aprepitant with other antiemetics experienced nausea and vomiting after being given cisplatin, while 44% of the patients who received cisplatin plus placebo had these symptoms.

In the Dutch trial, researchers noted that after six cycles of cisplatin, 59% of subjects who received aprepitant plus standard treatment did not experience symptoms, versus 34% who received the placebo plus standard therapy.

J Clin Oncol 2003;21:000-000.