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Drinković N, Beus M, Barbir R, Debeljak Ž, Tariba Lovaković B, Kalčec N, Ćurlin M, Bekavac A, Gorup D, Mamić I, Mandić D, Micek V, Turčić P, Günday-Türeli N, Türeli E, Vinković Vrček I. Novel PLGA-based nanoformulation decreases doxorubicin-induced cardiotoxicity. NANOSCALE 2024. [PMID: 38650478 DOI: 10.1039/d3nr06269d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Nanotechnology has the potential to provide formulations of antitumor agents with increased selectivity towards cancer tissue thereby decreasing systemic toxicity. This in vivo study evaluated the potential of novel nanoformulation based on poly(lactic-co-glycolic acid) (PLGA) to reduce the cardiotoxic potential of doxorubicin (DOX). In vivo toxicity of PLGADOX was compared with clinically approved non-PEGylated, liposomal nanoformulation of DOX (LipoDOX) and conventional DOX form (ConvDOX). The study was performed using Wistar Han rats of both sexes that were treated intravenously for 28 days with 5 doses of tested substances at intervals of 5 days. Histopathological analyses of heart tissues showed the presence of myofiber necrosis, degeneration processes, myocytolysis, and hemorrhage after treatment with ConvDOX, whereas only myofiber degeneration and hemorrhage were present after the treatment with nanoformulations. All DOX formulations caused an increase in the troponin T with the greatest increase caused by convDOX. qPCR analyses revealed an increase in the expression of inflammatory markers IL-6 and IL-8 after ConvDOX and an increase in IL-8 expression after lipoDOX treatments. The mass spectra imaging (MSI) of heart tissue indicates numerous metabolic and lipidomic changes caused by ConvDOX, while less severe cardiac damages were found after treatment with nanoformulations. In the case of LipoDOX, autophagy and apoptosis were still detectable, whereas PLGADOX induced only detectable mitochondrial toxicity. Cardiotoxic effects were frequently sex-related with the greater risk of cardiotoxicity observed mostly in male rats.
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Affiliation(s)
| | - Maja Beus
- Institute for Medical Research and Occupational Health, Zagreb, Croatia.
| | - Rinea Barbir
- Institute for Medical Research and Occupational Health, Zagreb, Croatia.
| | - Željko Debeljak
- JJ Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia
- University Hospital Osijek, Osijek, Croatia
| | | | - Nikolina Kalčec
- Institute for Medical Research and Occupational Health, Zagreb, Croatia.
| | | | - Ana Bekavac
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Dunja Gorup
- Department of Neuroradiology, Klinik für Neuroradiology, Universitätspital Zürich Universitätsspital Zürich, 8006 Zürich, Switzerland
| | - Ivan Mamić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | | | - Vedran Micek
- Institute for Medical Research and Occupational Health, Zagreb, Croatia.
| | - Petra Turčić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | | | | | - Ivana Vinković Vrček
- Institute for Medical Research and Occupational Health, Zagreb, Croatia.
- University of Rijeka, Faculty of Medicine, Rijeka, Croatia
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Wang Y, Song Y, He Y, Wang Y, Maurer J, Kiessling F, Lammers T, Wang F, Shi Y. Direct immunoactivation by chemotherapeutic drugs in cancer treatment. ADVANCED THERAPEUTICS 2023; 6:2300209. [PMID: 38249990 PMCID: PMC7615547 DOI: 10.1002/adtp.202300209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Indexed: 01/23/2024]
Abstract
The immune system plays a crucial role in recognizing and eliminating pathogenic substances and malignant cells in the body. For cancer treatment, immunotherapy is becoming the standard treatment for many types of cancer and is often combined with chemotherapy. Although chemotherapeutic agents are often reported to have adverse effects, including immunosuppression, they can also play a positive role in immunotherapy by directly stimulating the immune system. This has been demonstrated in preclinical and clinical studies in the past decades. Chemotherapeutics can activate immune cells through different immune receptors and signaling pathways depending on their chemical structure and formulation. In this review, we summarize and discuss the direct immunoactivation effects of chemotherapeutics and possible mechanisms behind these effects. Finally, we prospect chemo-immunotherapeutic combinations for the more effective and safer treatment of cancer.
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Affiliation(s)
- Yurui Wang
- Department of Polymer Therapeutics, Institute for Experimental Molecular Imaging, Uniklinik RWTH Aachen and Helmholtz Institute for Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen 52074, Germany
| | - Yiran Song
- Department of Gastroenterology, Shanghai 10th People's Hospital, School of Medicine, Tongji University, Shanghai 200040, PR China
| | - Yazhi He
- Department of Gastroenterology, Shanghai 10th People's Hospital, School of Medicine, Tongji University, Shanghai 200040, PR China
| | - Yang Wang
- Department of Gastroenterology, Shanghai 10th People's Hospital, School of Medicine, Tongji University, Shanghai 200040, PR China
| | - Jochen Maurer
- Department of Gynecology and Obstetrics, Uniklinik RWTH Aachen, Aachen 52074, Germany
| | - Fabian Kiessling
- Institute for Experimental Molecular Imaging, Uniklinik RWTH Aachen and Helmholtz Institute for Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen 52074, Germany
| | - Twan Lammers
- Institute for Experimental Molecular Imaging, Uniklinik RWTH Aachen and Helmholtz Institute for Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen 52074, Germany
| | - Feng Wang
- Department of Gastroenterology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, PR China
| | - Yang Shi
- Department of Polymer Therapeutics, Institute for Experimental Molecular Imaging, Uniklinik RWTH Aachen and Helmholtz Institute for Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen 52074, Germany
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3
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Maezawa M, Inoue M, Satake R, Wakabayashi W, Oura K, Miyasaka K, Hirofuji S, Goto F, Iwata M, Suzuki T, Tanaka H, Horibe M, Nakao S, Tsuji T, Ieiri I, Iguchi K, Nakamura M. Profiles and Outcomes of Skin Injuries Caused by Injectable Drug Extravasation: An Analysis of the Japanese Adverse Drug Event Report Database. JOURNAL OF INFUSION NURSING 2023; 46:281-293. [PMID: 37611286 DOI: 10.1097/nan.0000000000000517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Extravasation occurs when injectable drugs leak out of the blood vessels, damaging the surrounding tissues and causing a variety of skin injuries. This study aimed to comprehensively analyze extravasation risk, skin injury profiles, and outcomes for suspect drugs from the Japanese Adverse Drug Event Report (JADER) database. Adverse events were defined according to the Medical Dictionary for Regulatory Activities/Japanese version; the term extravasation (Standardized MedDRA Query Code: 20000136) was used in this analysis. The names of adverse events were entered as unified preferred terms and redefined to evaluate skin injury profiles. In addition, skin injury outcomes were divided into 2 broad categories: "improvement" and "no improvement." Reporting odds ratios were used to detect signals for adverse events. A total of 656 cases of extravasation-related adverse events were reported between April 2004 and January 2022. Signals for extravasation-related adverse events were detected from 11 drugs. Then, their respective skin injury profiles and outcomes were determined. These results suggest a relationship between adverse events associated with extravasation and 11 drugs and identify the characteristics of each skin injury and their outcomes. These findings will contribute to improving the quality of infusion management in clinical practice.
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Affiliation(s)
- Mika Maezawa
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Misaki Inoue
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Riko Satake
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Wataru Wakabayashi
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Keita Oura
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Koumi Miyasaka
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Sakiko Hirofuji
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Fumiya Goto
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Mari Iwata
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Takaaki Suzuki
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Hideyuki Tanaka
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Megumi Horibe
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Satoshi Nakao
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Toshikazu Tsuji
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Ichiro Ieiri
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Kazuhiro Iguchi
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Mitsuhiro Nakamura
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
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4
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Abe M, Iihara H, Aogi K. Fosnetupitant for the Prevention of Chemotherapy-Induced Nausea and Vomiting: A Short Review and Clinical Perspective. Adv Ther 2023; 40:1913-1925. [PMID: 36884027 PMCID: PMC10129973 DOI: 10.1007/s12325-023-02474-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/17/2023] [Indexed: 03/09/2023]
Abstract
Chemotherapy-induced nausea and vomiting (CINV) is often ranked by patients as one of the most distressing and feared consequences of chemotherapy. The novel neurokinin-1 (NK1) receptor antagonist fosnetupitant, a phosphorylated prodrug formulation of netupitant, was approved in Japan in 2022. Fosnetupitant is one of the standard treatments for the prevention of CINV in patients who are receiving highly (any treatment where CINV occurs in more than 90% of patients) or moderately (where CINV occurs in 30-90% of patients) emetogenic chemotherapies. The aim of this commentary is to describe the mechanism of action, tolerability, and antiemetic efficacy of single-agent fosnetupitant in the prevention of CINV, and to discuss its clinical application, in order to aid optimal use.
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Affiliation(s)
- Masakazu Abe
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | | | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
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5
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Saetang J, Tedasen A, Sangkhathat S, Sangkaew N, Dokduang S, Prompat N, Taraporn S, Graidist P. The attenuation effect of low piperine Piper nigrum extract on doxorubicin-induced toxicity of blood chemical and immunological properties in mammary tumour rats. PHARMACEUTICAL BIOLOGY 2022; 60:96-107. [PMID: 34962450 PMCID: PMC8735876 DOI: 10.1080/13880209.2021.2018470] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/26/2021] [Accepted: 12/10/2021] [Indexed: 06/01/2023]
Abstract
CONTEXT Many natural extracts have been shown to minimize the toxicity of doxorubicin (Dox). Low piperine Piper nigrum L. (Piperaceae) extract (PFPE) is a natural extract containing many types of antioxidants that may reduce Dox toxicities. OBJECTIVE To evaluate the effect of PFPE in attenuating the side effects of Dox. MATERIALS AND METHODS Tumour-bearing Sprague Dawley rats were divided into five groups including normal, vehicle, 100 mg/kg BW of PFPE plus 2 mg/kg BW of Dox (P100 + Dox), 100 mg/kg BW of PFPE plus 2 mg/kg BW of Dox (P200 + Dox) and Dox. Rats were treated with Dox and/or PFPE three times/week for 4 weeks. Tumour burden, blood parameters, weight of internal organs and immunological data were investigated. RESULTS The addition of 200 mg/kg PFPE significantly restored the levels of AST from 174.60 ± 45.67 U/L in the Dox group near to normal levels at 109.80 ± 4.99 U/L. The combination of PFPE and Dox also decreased the levels of CXCL7, TIMP-1, sICAM-1 and l-selectin about 1.4-1.6-fold compared to Dox group. Feeding rats with 200 mg/kg BW of PFPE combination with Dox slightly increased Th1 from 161.67 ± 14.28 cells in Dox group to 200.75 ± 5.8 cells meanwhile suppressed Treg from 3088 ± 78 cells in Dox to 2561 ± 71 cells. DISCUSSION AND CONCLUSIONS This study showed that PFPE ameliorated Dox toxicity in many aspects indicating the role of antioxidant and other substances in the extract on toxicity attenuation. This suggested the using of PFPE may be valuable for Dox treated patients.
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Affiliation(s)
- Jirakrit Saetang
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
- EZ-Mol-Design Laboratory, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Aman Tedasen
- Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Thai Buri, Thailand
| | - Surasak Sangkhathat
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Natnaree Sangkaew
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Sirinapa Dokduang
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Napat Prompat
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Siriporn Taraporn
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Potchanapond Graidist
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
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6
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Tyler T, Schultz A, Venturini A, Giuliano C, Bernareggi A, Spezia R, Voisin D, Stella V. Challenges in the Development of Intravenous Neurokinin-1 Receptor Antagonists: Results of a Safety and Pharmacokinetics Dose-Finding, Phase 1 Study of Intravenous Fosnetupitant. Clin Pharmacol Drug Dev 2022; 11:1405-1418. [PMID: 36263927 PMCID: PMC10092591 DOI: 10.1002/cpdd.1183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/18/2022] [Indexed: 01/28/2023]
Abstract
Oral NEPA is the fixed-combination antiemetic comprising netupitant (neurokinin-1 receptor antagonist [NK1 RA]) and palonosetron (5-hydroxytryptamine-3 receptor antagonist [5-HT3 RA]). Intravenous (IV) NEPA, containing fosnetupitant, a water-soluble N-phosphoryloxymethyl prodrug of netupitant, has been developed. Fosnetupitant does not require excipients or solubility enhancers often used to increase IV NK1 RA water solubility, preventing the occurrence of hypersensitivity and infusion-site reactions associated with these products. In this phase 1 study, subjects received a 30-minute placebo or fosnetupitant (17.6-353 mg) infusion and an oral NEPA or placebo capsule, with 2-sequence crossover treatment for fosnetupitant 118- to 353-mg dose cohorts. IV fosnetupitant safety and pharmacokinetics were evaluated, and its equivalence to an oral netupitant 300-mg dose was defined. Overall, 158 healthy volunteers were enrolled. All adverse events (AEs) were mild or moderate in intensity. Doppler-identified infusion-site asymptomatic thrombosis occurred in 5.4% (fosnetupitant) and 1.2% (oral NEPA) of subjects. The frequency or number of treatment-related AEs did not increase with ascending fosnetupitant doses. The most common treatment-related AEs were headache (fosnetupitant, 8.1%; oral NEPA, 12.7%) and constipation (fosnetupitant, 1.4%; oral NEPA, 7.5%). A fosnetupitant 235-mg dose was equivalent, in terms of netupitant exposure, to 300-mg oral netupitant. The safety profile of a single fosnetupitant 235-mg infusion was similar to that of single-dose oral NEPA.
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Affiliation(s)
- Timothy Tyler
- Comprehensive Cancer Center, Desert Regional Medical Center, Palm Springs, California, USA
| | - Armin Schultz
- CRS Clinical Research Services Mannheim GmbH, Mannheim, Germany
| | | | | | | | | | | | - Valentino Stella
- Pharmaceutical Chemistry, The University of Kansas, Lawrence, Kansas, USA
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7
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Matsuura K, Tsurutani J, Inoue K, Tanabe Y, Taira T, Kubota K, Tamura T, Saeki T. A phase 3 safety study of fosnetupitant as an antiemetic in patients receiving anthracycline and cyclophosphamide: CONSOLE-BC. Cancer 2022; 128:1692-1698. [PMID: 35045185 PMCID: PMC9306508 DOI: 10.1002/cncr.34088] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Fosnetupitant (FosNTP), an intravenous neurokinin 1 receptor antagonist, demonstrated a favorable safety profile with a potentially low risk of injection site reactions (ISRs) and promising antiemetic efficacy in patients receiving cisplatin‐based highly emetogenic chemotherapy in a previous phase 2 study. We conducted a randomized, double‐blind safety study to evaluate the safety profile of FosNTP, including ISRs, in patients receiving doxorubicin‐cyclophosphamide or epirubicin‐cyclophosphamide (AC/EC) chemotherapy. METHODS Patients scheduled to receive AC/EC were randomized 1:1 to receive 235 mg of FosNTP or 150 mg of fosaprepitant (FosAPR), both in combination with 0.75 mg of intravenous palonosetron and 9.9 mg of dexamethasone on day 1. The stratification factors were age category (<55 vs ≥55 years) and study site. The primary end point was the incidence of treatment‐related adverse events (TRAEs) with FosNTP. RESULTS Overall, 102 patients were randomized to FosNTP (n = 52) or FosAPR (n = 50), and all were treated with the study drug and evaluated for safety. The primary end point, the incidence of TRAEs, was similar with FosNTP (21.2%; 95% confidence interval [CI], 11.1%‐34.7%) and FosAPR (22.0%; 95% CI, 11.5%‐36.0%), with any‐cause ISRs observed in 5.8% and 26.0% of patients, respectively, and treatment‐related ISRs observed in 0% and 10.0%, respectively. The overall (0‐120 hour) complete response (defined as no emetic event and no rescue medication) rate, standardized by age category in the full analysis set, was 45.9% (23 of 51 patients) with FosNTP and 51.3% (25 of 49 patients) with FosAPR. CONCLUSIONS FosNTP demonstrated a favorable safety profile with a very low risk of ISRs in the AC/EC setting. Fosnetupitant shows a favorable safety profile in patients receiving doxorubicin‐cyclophosphamide or epirubicin‐cyclophosphamide chemotherapy. As an intravenous neurokinin 1 receptor antagonist with a low risk of causing injection site reactions, fosnetupitant may be used for protecting patients with cancer from experiencing chemotherapy‐induced nausea and vomiting.
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Affiliation(s)
- Kazuo Matsuura
- Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Junji Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan
| | - Kenichi Inoue
- Department of Breast Oncology, Saitama Cancer Center, Saitama, Japan
| | - Yuko Tanabe
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Tetsuhiko Taira
- Department of Medical Oncology, Sagara Hospital, Kagoshima, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Tomohide Tamura
- Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama, Japan
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8
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Hata A, Okamoto I, Inui N, Okada M, Morise M, Akiyoshi K, Takeda M, Watanabe Y, Sugawara S, Shinagawa N, Kubota K, Saeki T, Tamura T. Randomized, Double-Blind, Phase III Study of Fosnetupitant Versus Fosaprepitant for Prevention of Highly Emetogenic Chemotherapy-Induced Nausea and Vomiting: CONSOLE. J Clin Oncol 2022; 40:180-188. [PMID: 34793245 PMCID: PMC8718175 DOI: 10.1200/jco.21.01315] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/29/2021] [Accepted: 10/12/2021] [Indexed: 01/12/2023] Open
Abstract
PURPOSE We evaluated the efficacy and safety of fosnetupitant (FosNTP) versus fosaprepitant (FosAPR) for preventing highly emetogenic chemotherapy-induced nausea and vomiting. This phase III study was the first head-to-head comparison between two different neurokinin-1 receptor antagonists in combination with palonosetron and dexamethasone. PATIENTS AND METHODS Patients scheduled to receive cisplatin-based chemotherapy were randomly assigned 1:1 to FosNTP 235 mg or FosAPR 150 mg in combination with palonosetron 0.75 mg and dexamethasone. The primary end point was overall (0-120 hours) complete response (CR; no emetic event and no rescue medication) rate, stratified by sex and age category, to show the noninferiority of FosNTP to FosAPR (noninferiority margin, -10% for the difference in the overall CR rate). RESULTS Overall, 795 patients were randomly assigned, of whom 785 received the study drug (FosNTP [N = 392] v FosAPR [N = 393]) and were evaluated for efficacy and safety. The overall CR rate was 75.2% versus 71.0%, respectively (Mantel-Haenszel common risk difference, 4.1%; 95% CI, -2.1% to 10.3%), demonstrating noninferiority of FosNTP to FosAPR. The CR rates in the acute (0-24 hours), delayed (24-120 hours), and beyond delayed (120-168 hours) phases, and at 0-168 hours were 93.9% versus 92.6%, 76.8% versus 72.8%, 86.5% versus 81.4%, and 73.2% versus 66.9%, respectively. The incidence rates of treatment-related adverse events with FosNTP versus FosAPR were 22.2% versus 25.4%, whereas adverse events or treatment-related adverse events relevant to injection site reactions were 11.0% versus 20.6% (P < .001) and 0.3% versus 3.6% (P < .001), respectively. CONCLUSION FosNTP demonstrated noninferiority to FosAPR, with a favorable safety profile and lower risk for injection site reactions. Thus, FosNTP is valuable in the prophylaxis of acute, delayed, and beyond delayed chemotherapy-induced nausea and vomiting.
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Affiliation(s)
- Akito Hata
- Department of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| | - Isamu Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Inui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Morihito Okada
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | - Masahiro Morise
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kohei Akiyoshi
- Department of Clinical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Masayuki Takeda
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Yasutaka Watanabe
- Department of Thoracic Oncology, Saitama Cancer Center, Saitama, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Naofumi Shinagawa
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tomohide Tamura
- Thoracic Center, St Luke's International Hospital, Tokyo, Japan
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Hoogevest P, Tiemessen H, Metselaar JM, Drescher S, Fahr A. The Use of Phospholipids to Make Pharmaceutical Form Line Extensions. EUR J LIPID SCI TECH 2021. [DOI: 10.1002/ejlt.202000297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Peter Hoogevest
- Phospholipid Research Center Im Neuenheimer Feld 515 Heidelberg 69120D‐69120 Germany
| | - Harry Tiemessen
- Technical & Research Development PHAD PDU Specialty Novartis Campus Physical Garden (WSJ 177) 2.14 Basel CH‐4002 Switzerland
| | - Josbert M. Metselaar
- Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic Aachen D‐52074 Germany
- Institute for Biomedical Engineering, Faculty of Medicine RWTH Aachen University Aachen D‐52074 Germany
| | - Simon Drescher
- Phospholipid Research Center Im Neuenheimer Feld 515 Heidelberg D‐69120 Germany
| | - Alfred Fahr
- Professor Emeritus, Pharmaceutical Technology Friedrich‐Schiller‐University Jena Jena Germany
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Segna AN, Baron RH, Cohen B. Infusion Site Reactions: Classification in the Setting of Fosaprepitant Administration With Chemotherapy. Clin J Oncol Nurs 2020; 24:E79-E84. [PMID: 33216065 DOI: 10.1188/20.cjon.e79-e84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Studies report a wide range of incidence and severity of infusion site adverse events (ISAEs) following fosaprepitant administration. OBJECTIVES The purposes of this study were (a) to determine the incidence of suspected extravasation in patients with cancer receiving fosaprepitant infusions with chemotherapy and (b) to determine whether the documented signs, symptoms, and management strategies aligned with the diagnostic criteria for extravasation versus non-extravasation ISAEs. METHODS Electronic health records were used to identify patients who received fosaprepitant infusion with chemotherapy and had documentation for suspected extravasation. Chart reviews were conducted for a sample of patients to determine whether documentation was consistent with extravasation. FINDINGS About 3% (n = 460 of 15,667) of patients who received fosaprepitant had documentation for suspected extravasation. Among a random sample of patients (N = 110) with suspected extravasation, 6% (n = 6) had documentation consistent with extravasation.
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Aapro M, Navari RM, Roeland E, Zhang L, Schwartzberg L. Efficacy of intravenous NEPA, a fixed NK 1/5-HT 3 receptor antagonist combination, for the prevention of chemotherapy-induced nausea and vomiting (CINV) during cisplatin- and anthracycline cyclophosphamide (AC)-based chemotherapy: A review of phase 3 studies. Crit Rev Oncol Hematol 2020; 157:103143. [PMID: 33260048 DOI: 10.1016/j.critrevonc.2020.103143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 11/25/2022] Open
Abstract
This paper presents an overview of the efficacy of intravenous (IV) NEPA (fixed combination of the NK1RA, fosnetupitant, and 5-HT3RA, palonosetron) relative to oral NEPA and also to historical data for other NK1RA regimens. Data is compiled from 5 pivotal NEPA studies in adult chemotherapy-naïve patients with solid tumors undergoing either cisplatin- or anthracycline cyclophosphamide (AC)-based chemotherapy. Additionally, data was reviewed from 10 pivotal Phase 3 studies utilizing other NK1RA regimens approved for clinical use. The overall (0-120 h) complete response (no emesis, no rescue use), no emesis, and no significant nausea rates for IV NEPA were similar to that of oral NEPA and were consistently numerically higher than historical NK1RA regimens. As a single-dose prophylactic antiemetic combination given with dexamethasone, IV NEPA is a highly effective and convenient guideline-compliant antiemetic agent which may offer a safety benefit over other IV NK1RA regimens due to its lack of associated hypersensitivity and injection-site reactions.
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Affiliation(s)
- Matti Aapro
- Genolier Cancer Center, Clinique de Genolier, Case Postale 100, Route du Muids, Genolier, Switzerland.
| | - Rudolph M Navari
- Division of Hematology/Oncology, North Pavillion 2540K, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States
| | - Eric Roeland
- Oncology & Palliative Care, Massachusetts General Hospital Cancer Center, 55 Fruit Street, Boston, Massachusetts, United States
| | - Li Zhang
- Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou City, Guangdong Province, China
| | - Lee Schwartzberg
- Hematology & Oncology, West Cancer Center & Research Institute, 7945 Wolf River Boulevard, Germantown, Tennessee, United States
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Inherent and modifiable risk factors for peripheral venous catheter failure during cancer treatment: a prospective cohort study. Support Care Cancer 2020; 29:1487-1496. [PMID: 32710173 DOI: 10.1007/s00520-020-05643-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/17/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To identify modifiable and non-modifiable risk factors for peripheral intravenous catheter (PIV) failure among patients requiring intravenous treatment for oncology and haematology conditions. METHODS A single-centre prospective cohort study was conducted between October 2017 and February 2019. Adult in-patients requiring a PIV for therapy were prospectively recruited from two cancer units at a tertiary hospital in Queensland, Australia. The primary outcome was a composite of complications leading to PIV failure (local and bloodstream infection; occlusion; infiltration/extravasation; leakage; dislodgement; and/or phlebitis). Secondary outcomes were (i) PIV dwell time; (ii) insertion and (iii) failure of a CVAD; (iv) adverse events; (v) length of hospital stay. Outcomes were investigated using Bayesian multivariable linear regression modelling and survival analysis. RESULTS Of 200 participants, 396 PIVs were included. PIV failure incidence was 34.9%; the most common failure type was occlusion/infiltration (n = 74, 18.7%), then dislodgement (n = 33, 8.3%), and phlebitis (n = 30, 7.6%). While several patient and treatment risk factors were significant in univariable modelling, in the final multivariable model, only the use of non-sterile tape (external to the primary dressing) was significantly associated with decreased PIV dislodgement (hazard ratio 0.06, 95% confidence interval 0.01, 0.48; p = 0.008). CONCLUSION PIV failure rates among patients receiving cancer treatment are high, the sequelae of which may include delayed treatment and infection. Larger studies on risk factors and interventions to prevent PIV failure in this population are needed; however, the use of secondary securements (such as non-sterile tape) to provide further securement to the primary PIV dressing is particularly important. TRIAL REGISTRATION Study methods were registered prospectively with the Australian New Zealand Clinical Trials Registry on the 27th March 2017 (ACTRN12617000438358); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372191&isReview=true.
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Matsumoto K, Takahashi M, Sato K, Osaki A, Takano T, Naito Y, Matsuura K, Aogi K, Fujiwara K, Tamura K, Baba M, Tokunaga S, Hirano G, Imoto S, Miyazaki C, Yanagihara K, Imamura CK, Chiba Y, Saeki T. A double-blind, randomized, multicenter phase 3 study of palonosetron vs granisetron combined with dexamethasone and fosaprepitant to prevent chemotherapy-induced nausea and vomiting in patients with breast cancer receiving anthracycline and cyclophosphamide. Cancer Med 2020; 9:3319-3327. [PMID: 32168551 PMCID: PMC7221309 DOI: 10.1002/cam4.2979] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 11/07/2022] Open
Abstract
Purpose To investigate whether palonosetron is better than granisetron in preventing chemotherapy‐induced nausea and vomiting (CINV) in a three‐drug combination with dexamethasone and fosaprepitant (Fos) in patients with breast cancer who are placed on anthracycline and cyclophosphamide (AC‐based regimen). Patients and Methods Chemo‐naive women with primary breast cancer were randomly administered either palonosetron 0.75 mg (day 1) or granisetron 1 mg (day 1) combined with dexamethasone (12 mg at day 1, 8 mg at day 2 and day 3) and Fos 150 mg (day 1) before receiving AC‐based regimen in a double‐blind study. The primary endpoint was the complete response (CR) rate of emesis in cycle 1 in the delayed phase. This was defined as neither vomiting nor rescue drug usage for emesis at >24‐120 hours after chemotherapy. Secondary endpoints were the CR in the acute/overall phase (0‐24/0‐120 hours, respectively, after chemotherapy), no nausea and vomiting, Patient‐Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO‐CTCAE), and safety. Results From December 2012 to October 2014, 326 patients were treated and evaluated (164/162 evaluable patients in granisetron/palonosetron arm, respectively). The CR during the delayed phase was 60.4% in the granisetron regimen and 62.3% in the palonosetron regimen. The CR during acute phase (73.2% vs 75.9%, respectively) and the CR during overall phase (54.9% in both regimens) were very identical. A significantly higher number of patients in the palonosetron arm were free from nausea during the delayed phase (28% vs 40.1%; P = .029). Adverse events were also identical, although infusion site reactions (ISR) were higher (20.3%‐23.3%) than preceding studies in both regimens. Conclusion In combination with dexamethasone and Fos, this study suggests that palonosetron is not better than granisetron in chemo‐naive patients with primary breast cancer receiving AC‐based regimen. Administration of Fos in peripheral veins after AC‐based regimen increased ISR.
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Affiliation(s)
| | | | | | | | | | - Yoichi Naito
- National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | | | | | | | | | | | | | | | | | - Chiyo K Imamura
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan
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Schwartzberg L, Navari R, Clark‐Snow R, Arkania E, Radyukova I, Patel K, Voisin D, Rizzi G, Wickham R, Gralla RJ, Aapro M, Roeland E. Phase IIIb Safety and Efficacy of Intravenous NEPA for Prevention of Chemotherapy-Induced Nausea and Vomiting (CINV) in Patients with Breast Cancer Receiving Initial and Repeat Cycles of Anthracycline and Cyclophosphamide (AC) Chemotherapy. Oncologist 2020; 25:e589-e597. [PMID: 32162813 PMCID: PMC7066686 DOI: 10.1634/theoncologist.2019-0527] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 11/01/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND NEPA, a combination antiemetic of a neurokinin-1 (NK1 ) receptor antagonist (RA) (netupitant [oral]/fosnetupitant [intravenous; IV]) and 5-HT3 RA, palonosetron] offers 5-day CINV prevention with a single dose. Fosnetupitant solution contains no allergenic excipients, surfactant, emulsifier, or solubility enhancer. A phase III study of patients receiving cisplatin found no infusion-site or anaphylactic reactions related to IV NEPA. However, hypersensitivity reactions and anaphylaxis have been reported with other IV NK1 RAs, particularly fosaprepitant in patients receiving anthracycline-cyclophosphamide (AC)-based chemotherapy. This study evaluated the safety and efficacy of IV NEPA in the AC setting. MATERIALS AND METHODS This phase IIIb, multinational, randomized, double-blind study enrolled females with breast cancer naive to highly or moderately emetogenic chemotherapy. Patients were randomized to receive a single 30-minute infusion of IV NEPA or single oral NEPA capsule on day 1 prior to AC, in repeated (up to 4) cycles. Oral dexamethasone was given to all patients on day 1 only. RESULTS A total of 402 patients were included. The adverse event (AE) profiles were similar for IV and oral NEPA and consistent with those expected. Most AEs were mild or moderate with a similarly low incidence of treatment-related AEs in both groups. There were no treatment-related injection-site AEs and no reports of hypersensitivity or anaphylaxis. The efficacy of IV and oral NEPA were similar, with high complete response (no emesis/no rescue) rates observed in cycle 1 (overall [0-120 hours] 73.0% IV NEPA, 77.3% oral NEPA) and maintained over subsequent cycles. CONCLUSION IV NEPA was highly effective and safe with no associated hypersensitivity and injection-site reactions in patients receiving AC. IMPLICATIONS FOR PRACTICE As a combination of a neurokinin-1 (NK1 ) receptor antagonist (RA) and 5-HT3 RA, NEPA offers 5-day chemotherapy-induced nausea and vomiting prevention with a single dose and an opportunity to improve adherence to antiemetic guidelines. In this randomized multinational phase IIIb study, intravenous (IV) NEPA (fosnetupitant/palonosetron) was safe and highly effective in patients receiving multiple cycles of anthracycline-cyclophosphamide (AC)-based chemotherapy. Unlike other IV NK1 RAs, the IV NEPA combination solution does not require any surfactant, emulsifier, or solubility enhancer and contains no allergenic excipients. Hypersensitivity reactions and anaphylaxis have been reported with other IV NK1 RAs, most commonly with fosaprepitant in the AC setting. Importantly, there were no injection-site or hypersensitivity reactions associated with IV NEPA.
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Affiliation(s)
| | - Rudolph Navari
- Department of Hematology/Oncology, University of Alabama at BirminghamBirminghamAlabamaUSA
| | | | | | - Irena Radyukova
- Department of Chemotherapy, Clinical Oncology CenterOmskRussia
| | | | | | | | | | - Richard J. Gralla
- Department of Medical Oncology, Albert Einstein College of MedicineBronxNew YorkUSA
| | - Matti Aapro
- Cancer Centre, Clinique de GenolierGenolierSwitzerland
| | - Eric Roeland
- Oncology & Palliative Care, Massachusetts General Hospital Cancer CenterBostonMassachusettsUSA
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MORPHOHISTOLOGICAL CHARACTERISTICS OF THE HEART, LIVER AND KIDNEYS UNDER THE INFLUENCE OF DOXORUBICIN AND METABOLIC DRUGS. WORLD OF MEDICINE AND BIOLOGY 2020. [DOI: 10.26724/2079-8334-2020-4-74-184-188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Sugawara S, Inui N, Kanehara M, Morise M, Yoshimori K, Kumagai T, Fukui T, Minato K, Iwashima A, Takeda Y, Kubota K, Saeki T, Tamura T. Multicenter, placebo-controlled, double-blind, randomized study of fosnetupitant in combination with palonosetron for the prevention of chemotherapy-induced nausea and vomiting in patients receiving highly emetogenic chemotherapy. Cancer 2019; 125:4076-4083. [PMID: 31381152 PMCID: PMC6900104 DOI: 10.1002/cncr.32429] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/02/2019] [Accepted: 07/05/2019] [Indexed: 11/26/2022]
Abstract
Background The current randomized, double‐blind, phase 2 study assessed the efficacy and safety profile of a single intravenous administration of fosnetupitant, a neurokinin 1 receptor antagonist prodrug, for the prevention of chemotherapy‐induced nausea and vomiting in Japanese patients receiving cisplatin‐based chemotherapy. Methods Patients scheduled to receive cisplatin (at a dose of ≥70 mg/m2)‐based regimens were randomly assigned to receive fosnetupitant at a dose of 81 mg or 235 mg or placebo in combination with palonosetron at a dose of 0.75 mg and dexamethasone. The primary endpoint was complete response (CR; no vomiting and no rescue medication) during the overall phase (0‐120 hours). The overall CR rate was compared between each dose of fosnetupitant and the placebo group adjusting for the stratification factors of sex and age class (age <55 years vs age ≥55 years). Safety was assessed, with special attention given to events that potentially were suggestive of infusion site reactions. Results A total of 594 patients were randomized. Of these, 194 patients, 195 patients, and 195 patients, respectively, in the placebo and fosnetupitant 81‐mg and 235‐mg dose groups were evaluable for efficacy. The overall CR rate was 54.7% for the placebo group, 63.8% for the fosnetupitant 81‐mg dose group (adjusted difference, 9.1%; 95% CI, ‐0.4% to 18.6% [P = .061]), and 76.8% for the fosnetupitant 235‐mg dose group (adjusted difference, 22.0%; 97.5% CI, 11.7% to 32.3% [P < .001]). Safety profiles were comparable between the 3 groups. The incidence of infusion site reactions related to fosnetupitant was ≤1% in each dose group. Conclusions Fosnetupitant at a dose of 235 mg provided superior prevention of chemotherapy‐induced nausea and vomiting among patients receiving cisplatin‐based chemotherapy compared with the control group, and with a satisfactory safety profile. Fosnetupitant at a dose of 235 mg combined with palonosetron and dexamethasone was demonstrated to be effective in the prevention of emesis during the first 0 to 120 hours after the administration of cisplatin. The results of the current study suggest that fosnetupitant at a dose of 235 mg also may improve the percentage of patients with no nausea in the delayed phase (24 ‐ 120 hours after cisplatin administration), which is an unmet medical need of patients with cancer who are receiving chemotherapy.
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Affiliation(s)
- Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Naoki Inui
- Respiratory Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Masashi Kanehara
- Department of Respiratory Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Masahiro Morise
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Kozo Yoshimori
- Department of Clinical Oncology, Fukujuji Hospital, Tokyo, Japan
| | - Toru Kumagai
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Tomoya Fukui
- Department of Respiratory Medicine, Kitasato University School of Medicine, Kanagawa, Japan
| | - Koichi Minato
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Gunma, Japan
| | - Akira Iwashima
- Department of Respiratory Medicine, Nagaoka Chuo General Hospital, Niigata, Japan
| | - Yuichiro Takeda
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tomohide Tamura
- Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
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Navari RM. Safety profile of HTX-019 administered as an intravenous push in cancer patients: a retrospective review. Expert Opin Drug Saf 2019; 19:205-210. [PMID: 31709853 DOI: 10.1080/14740338.2020.1691521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: HTX-019 (Cinvanti®) is a novel injectable emulsion formulation of the neurokinin 1 receptor antagonist (RA) aprepitant, approved (as 30-min infusion and 2-min injection) for preventing acute and delayed chemotherapy-induced nausea and vomiting (CINV). This retrospective analysis evaluated the safety of HTX-019 administered by 2-min injection in patients with cancer.Methods: At a single center, HTX-019 was evaluated as a 2-min injection within a guideline-recommended three-drug regimen for CINV prophylaxis in patients receiving highly (HEC) or moderately emetogenic chemotherapy (MEC). Treatment-emergent adverse events (TEAEs) were assessed 0-60 minutes following initiation of HTX-019 administration, focusing on infusion-site adverse events and hypersensitivity reactions.Results: Among 600 patients (78 MEC, 522 HEC), the most common diagnoses were lung (172) and breast (129) cancer. Patients received a 2-min injection of HTX-019, followed by a 5-hydroxytryptamine type 3 RA intravenously (IV) (palonosetron or ondansetron), dexamethasone IV, and chemotherapy regimen (most common was cisplatin-containing) via a central (76%) and peripheral line (24%). No TEAEs occurred within 60 min after start of HTX-019 administration.Conclusion: HTX-019 administered by 2-min injection has a tolerable safety profile in patients with cancer, representing a viable method of HTX-019 administration for CINV prevention.
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Affiliation(s)
- Rudolph M Navari
- Division of Hematology Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
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Yamasaki M, Kimura R, Mayahara S, Maeda Y, Takahashi M, Nishida T, Oda K, Murakami T. Study on the infusion-site adverse events and vascular distribution of epirubicin in chemotherapy with epirubicin and fosaprepitant. Mol Clin Oncol 2019; 11:43-49. [PMID: 31289676 PMCID: PMC6535639 DOI: 10.3892/mco.2019.1849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 04/15/2019] [Indexed: 11/06/2022] Open
Abstract
In breast cancer patients on a fluorouracil-epirubicin (EPI)-cyclophosphamide (FEC) regimen and intravenous fosaprepitant (FAP) during chemotherapy, infusion-site adverse events such as vascular pain and induration and/or phlebitis are observed. In the present study, adverse events induced by the FEC regimen and FAP, a prodrug of aprepitant (AP), were studied based on the vascular tissue distribution of EPI in rats. Rats were treated with intravenous FAP (3 mg/kg, 10 min-constant rate infusion) or oral AP (3 mg/kg) and then intravenous EPI (1 mg/kg, 5 min-constant rate infusion) as follows: FAP-S Group, FAP and then EPI was infused from the same site on the jugular vein; FAP-D Group, FAP and then EPI was infused from different jugular veins (left and right); and AP Group, AP was administered orally and EPI was infused from the jugular vein. Concentrations of EPI in vascular tissue at the EPI infusion sites and opposite sites of the jugular vein (left and right, respectively) were measured at 30 min and 24 h after EPI infusion. Histological observation of the EPI infusion site was also made separately. In rats, the tissue concentrations of EPI at the infusion site in the FAP-S group were higher than those in the FAP-D and AP groups. Inflammation and necrosis were observed at the EPI infusion-site vascular tissue of the FAP-S group, but not of the FAP-D and AP groups. These findings could aid the development of an approach to avoid infusion-site adverse events in anthracycline-based chemotherapy in the clinical practice.
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Affiliation(s)
- Miho Yamasaki
- Department of Pharmacy, Chugoku Rosai Hospital, Kure, Hiroshima 737-0193, Japan
| | - Ryuji Kimura
- Department of Pharmacy, Chugoku Rosai Hospital, Kure, Hiroshima 737-0193, Japan
| | - Shigeri Mayahara
- Department of Pharmacy, Chugoku Rosai Hospital, Kure, Hiroshima 737-0193, Japan
| | - Yorinobu Maeda
- Department of Pharmacy, Chugoku Rosai Hospital, Kure, Hiroshima 737-0193, Japan
| | - Mamoru Takahashi
- Department of Breast Surgery, Chugoku Rosai Hospital, Kure, Hiroshima 737-0193, Japan
| | - Toshihiro Nishida
- Department of Diagnostic Pathology, Chugoku Rosai Hospital, Kure, Hiroshima 737-0193, Japan
| | - Keisuke Oda
- Laboratory of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmaceutical Sciences, Hiroshima International University, Kure, Hiroshima 737-0112, Japan
| | - Teruo Murakami
- Laboratory of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmaceutical Sciences, Hiroshima International University, Kure, Hiroshima 737-0112, Japan
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Karthaus M, Schiel X, Ruhlmann CH, Celio L. Neurokinin-1 receptor antagonists: review of their role for the prevention of chemotherapy-induced nausea and vomiting in adults. Expert Rev Clin Pharmacol 2019; 12:661-680. [PMID: 31194593 DOI: 10.1080/17512433.2019.1621162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: The addition of neurokinin-1 receptor antagonists (NK1RAs) to standard prophylaxis of 5-hydroxytryptamine-3 RA (5-HT3RA) plus dexamethasone more effectively prevents chemotherapy-induced nausea and vomiting (CINV) associated with highly and moderately emetogenic chemotherapy. Areas covered: This review presents the evidence base for the use of oral and intravenous (IV) NK1RAs, focusing on the pharmacologic and clinical properties as a class, and highlighting differences between agents. A PubMed literature search was conducted from 2000 to 2018. Expert opinion: Adherence to international antiemetic guidelines remains a clinical challenge. Strategies to simplify antiemetic regimens and facilitate their administration may improve compliance and treatment outcomes. The use of fixed-combination antiemetics offers clinical utility, in combining an NK1RA with a 5-HT3RA in a single oral dose. The use of long-lasting NK1RAs and administering CINV prophylaxis closer to the time of chemotherapy may also assist with guideline and treatment compliance, diminishing the need for home-based administration, and potentially reducing resource utilization. The availability of IV and oral formulations of NK1RAs and NK1RA-5-HT3RA fixed combinations offers further utility, particularly for those patients unsuited for oral administration. However, safety considerations with respect to injection site toxicity and hypersensitivity reactions of the new NK1RA IV formulations deserve close attention.
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Affiliation(s)
- Meinolf Karthaus
- a Department of Hematology, Oncology and Palliative Care , Klinikum Neuperlach , Munich , Germany.,b Department of Hematology, Oncology and Palliative Care , Klinikum Harlaching , Munich , Germany
| | - Xaver Schiel
- b Department of Hematology, Oncology and Palliative Care , Klinikum Harlaching , Munich , Germany
| | | | - Luigi Celio
- d Department of Medical Oncology and Hematology , Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
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Bigdeli Shamloo MB, Nasiri M, Maneiy M, Dorchin M, Mojab F, Bahrami H, Naseri MS, Kiarsi M. Effects of topical sesame (Sesamum indicum) oil on the pain severity of chemotherapy-induced phlebitis in patients with colorectal cancer: A randomized controlled trial. Complement Ther Clin Pract 2019; 35:78-85. [DOI: 10.1016/j.ctcp.2019.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 12/14/2022]
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Walton GD. Safety Profile of HTX-019 Administered as an Intravenous Push in Cancer Patients: A Retrospective Review. Adv Ther 2019; 36:662-669. [PMID: 30706408 PMCID: PMC6824338 DOI: 10.1007/s12325-019-0877-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION HTX-019 [CINVANTI® (aprepitant injectable emulsion)] is a neurokinin 1 receptor antagonist (NK-1 RA) approved as a 30-min infusion for preventing acute and delayed chemotherapy-induced nausea and vomiting. HTX-019 has been generally well tolerated when administered as a 30-min infusion or 2-min injection [intravenous (IV) push] in healthy subjects. This real-world analysis assesses safety of HTX-019 via IV push in patients with cancer and addresses a recent IV bag shortage. METHODS This retrospective review involved six sites in Alabama, USA. Analyzed patients were 18-94 years old with an Eastern Cooperative Oncology Group performance status ranging from 0 to 4. Seventy-six chemotherapy regimens were utilized (emetogenicity high, n = 35; moderate, n = 35; low, n = 6) and patients received HTX-019 130 mg only or switched from fosaprepitant 150 mg to HTX-019 130 mg within a three-drug antiemetic regimen with a 5-hydroxytryptamine type 3 RA and dexamethasone. HTX-019 was administered via IV push. Electronic medical records of patients receiving HTX-019 were queried for nursing and medical documentation associated with infusion-site adverse events (ISAEs). The detailed notes were also reviewed for any discontinuation of HTX-019 or substitution of HTX-019 with another NK-1 RA. RESULTS The HTX-019 safety profile was analyzed on the basis of 2066 IV push administrations in 591 cancer patients (most common diagnoses: lung, n = 107; breast, n = 100; colon, n = 92). No clinically significant ISAEs or adverse events associated with HTX-019 were reported. Also, no patients discontinued HTX-019 treatment, and none switched from HTX-019 to another NK-1 RA. CONCLUSION This is the first study to demonstrate that HTX-019 can be safely administered via IV push in patients with cancer receiving emetogenic chemotherapy while negating the need for fluid bags, which are scarce. FUNDING Heron Therapeutics, Inc., San Diego, CA, USA. Plain language summary available for this article.
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Affiliation(s)
- Gary D Walton
- Department of Pharmacy, Clearview Cancer Institute, Huntsville, AL, USA.
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Boccia R, Geller RB, Clendeninn N, Ottoboni T. Hypersensitivity and infusion-site adverse events with intravenous fosaprepitant after anthracycline-containing chemotherapy: a retrospective study. Future Oncol 2019; 15:297-303. [DOI: 10.2217/fon-2018-0662] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Aim: Fosaprepitant, an intravenous neurokinin-1 receptor antagonist for chemotherapy-induced nausea and vomiting, contains polysorbate 80, which is associated with infusion-site adverse events (ISAEs) and hypersensitivity systemic reactions (HSRs). This study investigated ISAEs/HSRs following fosaprepitant with anthracycline-containing chemotherapy. Patients & methods: This retrospective chart review noted ISAEs/HSRs following the anthracycline doxorubicin+cyclophosphamide and a three-drug fosaprepitant regimen, via peripheral line. Results: 35/127 patients (28%) developed ISAEs/HSRs with chemotherapy and antiemetic therapy: 32 developed 137 individual ISAEs, primarily erythema, pain and catheter-site swelling; 16 developed 50 individual HSRs, primarily edema/swelling, erythema or dermatitis (no anaphylaxis). Conclusion: Fosaprepitant is associated with a significant ISAE/HSR rate following anthracycline-containing chemotherapy via peripheral line. Polysorbate 80-free intravenous neurokinin-1 receptor antagonist may provide a safer chemotherapy-induced nausea and vomiting prophylaxis option.
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Affiliation(s)
- Ralph Boccia
- Center for Cancer & Blood Disorders, 6410 Rockledge Drive, #660, Bethesda, MD 20817, USA
| | - Robert B Geller
- Heron Therapeutics, Inc., 4242 Campus Point Court, Suite 200, San Diego, CA 92121, USA
| | - Neil Clendeninn
- Heron Therapeutics, Inc., 4242 Campus Point Court, Suite 200, San Diego, CA 92121, USA
| | - Thomas Ottoboni
- Heron Therapeutics, Inc., 4242 Campus Point Court, Suite 200, San Diego, CA 92121, USA
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Navari RM. HTX-019: polysorbate 80- and synthetic surfactant-free neurokinin 1 receptor antagonist for chemotherapy-induced nausea and vomiting prophylaxis. Future Oncol 2018; 15:241-255. [PMID: 30304952 DOI: 10.2217/fon-2018-0577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chemotherapy-induced nausea and vomiting (CINV) may occur during the acute (0-24 h) or delayed (25-120 h) phase following chemotherapy administration. The addition of a neurokinin 1 receptor antagonist to antiemetic regimens containing a 5-hydroxytryptamine type 3 receptor antagonist and dexamethasone has resulted in improved CINV prophylaxis. Due to numerous adverse events and hypersensitivity reactions associated with fosaprepitant, a commonly used neurokinin 1 receptor antagonist, there remains an unmet need for better-tolerated formulations. HTX-019, the US FDA-approved polysorbate 80- and synthetic surfactant-free aprepitant injectable emulsion, is bioequivalent to and better tolerated (fewer treatment-emergent adverse events) than fosaprepitant. HTX-019 represents a valuable alternative to fosaprepitant for CINV prophylaxis.
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Affiliation(s)
- Rudolph M Navari
- Department of Medicine, University of Alabama Birmingham, 1802 Sixth Avenue, North Pavilion 2540K, Birmingham, AL 35294, USA
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Ottoboni T, Lauw M, Keller MR, Cravets M, Manhard K, Clendeninn N, Quart B. Safety of HTX-019 (intravenous aprepitant) and fosaprepitant in healthy subjects. Future Oncol 2018; 14:2849-2859. [PMID: 29873529 DOI: 10.2217/fon-2018-0311] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Evaluate safety of HTX-019, a novel polysorbate 80- and synthetic surfactant-free intravenous formulation of neurokinin 1 receptor antagonist aprepitant for chemotherapy-induced nausea and vomiting. METHODS Two open-label, randomized, two-way crossover studies evaluated treatment-emergent adverse events (TEAEs) in 200 healthy subjects. Subjects received HTX-019 130 mg (30-min infusion) and fosaprepitant 150 mg (20- or 30-min infusion), with ≥7-day washout between doses. RESULTS Less than or equal to 30 min after start of infusion, TEAEs occurred in 5 (3%) HTX-019 and 30 (15%) fosaprepitant recipients. No HTX-019 recipients had infusion-site adverse events, versus 15 (8%) fosaprepitant recipients. Treatment-related dyspnea occurred in one HTX-019 and six fosaprepitant recipients. No severe/serious TEAEs occurred; all TEAEs resolved. CONCLUSION HTX-019 may provide a safer aprepitant formulation than fosaprepitant for chemotherapy-induced nausea and vomiting prevention.
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Affiliation(s)
- Tom Ottoboni
- Pharmaceutical & Translational Sciences, Heron Therapeutics, Inc., 4242 Campus Point Court, Suite 200, San Diego, CA 92121, USA
| | - Michael Lauw
- Clinical Operations, Heron Therapeutics, Inc., 4242 Campus Point Court, Suite 200, San Diego, CA 92121, USA
| | - Mary Rose Keller
- Clinical Operations, Heron Therapeutics, Inc., 4242 Campus Point Court, Suite 200, San Diego, CA 92121, USA
| | - Matt Cravets
- Biometrics, Heron Therapeutics, Inc., 4242 Campus Point Court, Suite 200, San Diego, CA 92121, USA
| | - Kimberly Manhard
- Drug Development, Heron Therapeutics, Inc., 4242 Campus Point Court, Suite 200, San Diego, CA 92121, USA
| | - Neil Clendeninn
- Clinical Operations, Heron Therapeutics, Inc., 4242 Campus Point Court, Suite 200, San Diego, CA 92121, USA
| | - Barry Quart
- Clinical, Heron Therapeutics, Inc., 4242 Campus Point Court, Suite 200, San Diego, CA 92121, USA
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Abstract
Polysorbate 80 is a synthetic nonionic surfactant used as an excipient in drug formulation. Various products formulated with polysorbate 80 are used in the oncology setting for chemotherapy, supportive care, or prevention, including docetaxel, epoetin/darbepoetin, and fosaprepitant. However, polysorbate 80, like some other surfactants, is not an inert compound and has been implicated in a number of systemic and injection- and infusion-site adverse events (ISAEs). The current formulation of intravenous fosaprepitant has been associated with an increased risk of hypersensitivity systemic reactions (HSRs). Factors that have been associated with an increased risk of fosaprepitant-related ISAEs include the site of administration (peripheral vs. central venous), coadministration of anthracycline-based chemotherapy, number of chemotherapy cycles or fosaprepitant doses, and concentration of fosaprepitant administered. Recently, two polysorbate 80-free agents have been approved: intravenous rolapitant, which is a neurokinin 1 (NK-1) receptor antagonist formulated with the synthetic surfactant polyoxyl 15 hydroxystearate, and intravenous HTX-019, which is a novel NK-1 receptor antagonist free of synthetic surfactants. Alternative formulations will obviate the polysorbate 80-associated ISAEs and HSRs and should improve overall management of chemotherapy-induced nausea and vomiting.Funding Heron Therapeutics, Inc.
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Affiliation(s)
- Lee S Schwartzberg
- Division of Hematology/Oncology, Department of Medicine, University of Tennessee Health Science Center and West Cancer Center, Memphis, TN, USA.
| | - Rudolph M Navari
- Division of Hematology and Oncology, University of Alabama Birmingham, Birmingham, AL, USA
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Chau E, Lundberg J, Phillips G, Berger M, Wesolowski R. Updated report on incidence of infusion-site reactions associated with peripheral intravenous administration of fosaprepitant. J Oncol Pharm Pract 2018; 25:1053-1057. [DOI: 10.1177/1078155218769347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Eric Chau
- The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University, Columbus, USA
| | - Jordan Lundberg
- The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University, Columbus, USA
| | - Gary Phillips
- Center for Biostatistics, The Ohio State University, Columbus, USA
| | - Michael Berger
- The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University, Columbus, USA
| | - Robert Wesolowski
- The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University, Columbus, USA
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Ottoboni T, Keller MR, Cravets M, Clendeninn N, Quart B. Bioequivalence of HTX-019 (aprepitant IV) and fosaprepitant in healthy subjects: a Phase I, open-label, randomized, two-way crossover evaluation. DRUG DESIGN DEVELOPMENT AND THERAPY 2018. [PMID: 29535504 PMCID: PMC5837372 DOI: 10.2147/dddt.s155875] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction Fosaprepitant, an intravenous (IV) aprepitant prodrug for chemotherapy-induced nausea and vomiting prophylaxis, is associated with systemic and infusion-site reactions attributed in part to its surfactant, polysorbate 80. HTX-019 is an IV aprepitant formulation free of polysorbate 80 and other synthetic surfactants. Materials and methods This open-label, single-dose, randomized, two-way crossover bioequivalence study compared pharmacokinetics and safety of HTX-019 and fosaprepitant. Healthy subjects received single-dose HTX-019 (130 mg) or fosaprepitant (150 mg) IV over 30 min, with ≥7-day washout between doses. Blood samples were evaluated for pharmacokinetics and bioequivalence; safety evaluation included treatment-emergent adverse events (TEAEs) and serious adverse events. Ninety-seven of one hundred enrolled subjects completed the study. Results Baseline characteristics were comparable between treatment sequences. For HTX-019, mean (percent coefficient of variation) area under the curve (AUC) from time 0 to time of last measurable plasma concentration (AUC0−t), AUC from time 0 to infinity (AUC0−inf), and plasma concentration at 12 h (C12 h) for HTX-019 were 43,729 h*ng/mL (32.7), 45,460 h*ng/mL (36.8), and 988.4 ng/mL (27.5), respectively; corresponding fosaprepitant values were 44,130 h*ng/mL (32.0), 46,163 h*ng/mL (36.6), and 1,022 ng/mL (28.5). Also, 90% CIs (94.186–101.354) were within bioequivalence bounds (80%–125%). Within 1 h following infusion start, one (1%) HTX-019 recipient reported one TEAE, while 20 (20%) fosaprepitant recipients reported 32 TEAEs. Dyspnea occurred in three fosaprepitant recipients (at <1 min in two subjects and at 18 min in one subject, considered study drug related) and one HTX-019 recipient (at 120 h, associated with a respiratory tract infection and considered not related to the study drug). No severe TEAEs, serious adverse events, or deaths occurred; all TEAEs resolved. Conclusion HTX-019 was bioequivalent to fosaprepitant and may provide a safer alternative to fosaprepitant for chemotherapy-induced nausea and vomiting prophylaxis.
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Affiliation(s)
- Tom Ottoboni
- Pharmaceutical and Translational Sciences, Heron Therapeutics, Inc., San Diego, CA, USA
| | - Mary Rose Keller
- Clinical Operations, Heron Therapeutics, Inc., San Diego, CA, USA
| | - Matt Cravets
- Biometrics, Heron Therapeutics, Inc., San Diego, CA, USA
| | | | - Barry Quart
- Heron Therapeutics, Inc., San Diego, CA, USA
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Lian L, Song WS, Ping Z, Ru S, Hong YS. External application of moisture exposed burn ointment for phlebitis: A meta-analysis of randomized
controlled trials. ACTA ACUST UNITED AC 2017. [DOI: 10.5897/ijmms2017.1310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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29
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Gonçalves SC, Sanches SM, Bueno CT, Villela de Castro DL, Damascena A, Santos GRC. Incidence of Infusion Site Reactions in Peripheral Fosaprepitant Infusions. JOURNAL OF INFUSION NURSING 2017; 40:380-383. [PMID: 29112587 DOI: 10.1097/nan.0000000000000252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Fosaprepitant is administered intravenously to treat chemotherapy-induced nausea and vomiting. To verify the incidence of infusion site reactions and the relationship among risk factors, a quantitative retrospective cohort study was undertaken. The study included patients seen between October 2013 and February 2014. Fifty-seven patients were included in the study, and there were 105 infusions among them. Infusion site reactions were identified in 42 (40%) cases. Risk factors identified by the study included age (P < .001), insertion at the back of the hand and wrist (P < .001), and first fosaprepitant administration (P < .001). The study found evidence of a higher incidence of infusion site reactions than was reported in the package insert.
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Affiliation(s)
- Sarah C Gonçalves
- A.C. Camargo Cancer Center, São Paulo, Brazil. Sarah C. Gonçalves, MSc, RN, is a nurse coordinator at the AC Camargo Cancer Center in São Paulo, Brazil. Solange M. Sanches, MD, PhD, is head of the Clinical Oncology Department at the AC Camargo Cancer Center in São Paulo, Brazil. Camila T. Bueno, RN, is an oncology nurse in the Chemotherapy Center at the A.C. Camargo Cancer Center in São Paulo, Brazil. Diana L. Villela de Castro, PhD, RN, is a senior nurse in the Continuing Education Department at the A.C. Camargo Cancer Center in São Paulo, Brazil. Aline Damascena, MSc, BS, is a statistician at the A.C. Camargo Cancer Center in São Paulo, Brazil. Giseli R.C. Santos, RN, is a nurse coordinator in the Risk Management Department of the A.C. Camargo Cancer Center in São Paulo, Brazil
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Pritchett W, Kinsley K. Benefits and Risks of Fosaprepitant in Patients Receiving Emetogenic Regimens. Clin J Oncol Nurs 2016; 20:555-6. [PMID: 27668376 DOI: 10.1188/16.cjon.555-556] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Fosaprepitant dimeglumine (Emend IV®) is an IV antiemetic that may be beneficial to patients receiving highly emetogenic regimens. Aprepitant (Emend®) is an oral medication that is administered for three consecutive days, whereas fosaprepitant is a single-dose IV medication that is administered on the day of chemotherapy for 20-30 minutes (depending on the IV access type). Fosaprepitant may be useful, yet it can also present a risk for hypersensitivity reactions and phlebitis. Oncology nurses must be aware of the signs and symptoms of these potential adverse events to properly care for their patients.
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31
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Wang L, Chen Q, Qi H, Wang C, Wang C, Zhang J, Dong L. Doxorubicin-Induced Systemic Inflammation Is Driven by Upregulation of Toll-Like Receptor TLR4 and Endotoxin Leakage. Cancer Res 2016; 76:6631-6642. [PMID: 27680684 DOI: 10.1158/0008-5472.can-15-3034] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 08/10/2016] [Accepted: 09/06/2016] [Indexed: 11/16/2022]
Abstract
Doxorubicin is one of the most effective chemotherapeutic agents used for cancer treatment, but it causes systemic inflammation and serious multiorgan side effects in many patients. In this study, we report that upregulation of the proinflammatory Toll-like receptor TLR4 in macrophages by doxorubicin is an important step in generating its toxic side effects. In patient serum, doxorubicin treatment resulted in leakage of endotoxin and inflammatory cytokines into circulation. In mice, doxorubicin damaged the intestinal epithelium, which also resulted in leakage of endotoxin from the gut flora into circulation. Concurrently, doxorubicin increased TLR4 expression in macrophages both in vitro and in vivo, which further enhanced the sensitivity of these cells to endotoxin. Either depletion of gut microorganisms or blockage of TLR4 signaling effectively decreased doxorubicin-induced toxicity. Taken together, our findings suggest that doxorubicin-triggered leakage of endotoxin into the circulation, in tandem with enhanced TLR4 signaling, is a candidate mechanism underlying doxorubicin-induced systemic inflammation. Our study provides new insights for devising relevant strategies to minimize the adverse effects of chemotherapeutic agents such as doxorubicin, which may extend its clinical uses to eradicate cancer cells. Cancer Res; 76(22); 6631-42. ©2016 AACR.
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Affiliation(s)
- Lintao Wang
- State Key Laboratory of Pharmaceutical Biotechnology, NJU Advanced Institute for Life Sciences (NAILS), School of life sciences, Nanjing University, Nanjing, China
| | - Qian Chen
- State Key Laboratory of Pharmaceutical Biotechnology, NJU Advanced Institute for Life Sciences (NAILS), School of life sciences, Nanjing University, Nanjing, China
| | - Haixia Qi
- State Key Laboratory of Pharmaceutical Biotechnology, NJU Advanced Institute for Life Sciences (NAILS), School of life sciences, Nanjing University, Nanjing, China
| | - Chunming Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR
| | - Cheng Wang
- State Key Laboratory of Pharmaceutical Biotechnology, NJU Advanced Institute for Life Sciences (NAILS), School of life sciences, Nanjing University, Nanjing, China.,Department of Clinical Laboratory, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Junfeng Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, NJU Advanced Institute for Life Sciences (NAILS), School of life sciences, Nanjing University, Nanjing, China.
| | - Lei Dong
- State Key Laboratory of Pharmaceutical Biotechnology, NJU Advanced Institute for Life Sciences (NAILS), School of life sciences, Nanjing University, Nanjing, China.
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Candelario N, Lu MLR. Fosaprepitant dimeglumine for the management of chemotherapy-induced nausea and vomiting: patient selection and perspectives. Cancer Manag Res 2016; 8:77-82. [PMID: 27382332 PMCID: PMC4922819 DOI: 10.2147/cmar.s93620] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Chemotherapy-induced nausea and vomiting (CINV) is a debilitating side effect of antineoplastic agents. Several treatment regimens are used to address this problem. Fosaprepitant is a neurokinin-1 receptor blocker used in the prevention and treatment of CINV, especially for moderately and severely emetogenic chemotherapy. It is highly effective in the treatment of delayed CINV. Data from previous studies show that fosaprepitant is noninferior to aprepitant in the management of CINV. Fosaprepitant is given as a single-dose intravenous infusion, thus offering better patient compliance. The dose-limiting side effect of fosaprepitant is an infusion-related reaction, ranging from pain at the infusion site to thrombophlebitis. This side effect has been reported with coadministration of anthracycline agents.
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Lorusso V. Management of chemotherapy-induced nausea and vomiting by risk profile: role of netupitant/palonosetron. Ther Clin Risk Manag 2016; 12:917-25. [PMID: 27354807 PMCID: PMC4907706 DOI: 10.2147/tcrm.s89215] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
As recommended by most recent antiemetic guidelines, the optimal prophylaxis of chemotherapy-induced nausea and vomiting (CINV) requires the combination of 5-HT3 receptor antagonist (RA) with an NK1-RA. Moreover, the major predictors of acute and delayed CINV include: young age, female sex, platinum- or anthracycline-based chemotherapy, nondrinker status, emesis in the earlier cycles of chemotherapy, and previous history of motion/morning sickness. Despite improved knowledge of the pathophysiology of CINV and advances in the availability of active antiemetics, an inconsistent compliance with their use has been reported, thereby resulting in suboptimal control of CINV in several cases. In this scenario, a new anti-emetic drug is now available, which seems to be able to guarantee better prophylaxis of CINV and improvement of adherence to guidelines. In fact, netupitant/palonosetron (NEPA) is a ready-to-use single oral capsule, combining an NK1-RA (netupitant) and a 5-HT3-RA (palonosetron), which is to be taken 1 hour before the administration of chemotherapy, ensuring the coverage from CINV for 5 days. We reviewed the role of NEPA in patients at high risk of CINV receiving highly emetogenic chemotherapy. In these patients, NEPA plus dexamethasone, as compared to standard treatments, achieved superior efficacy in all primary and secondary end points during the acute, delayed, and overall phases, including nausea assessment. Moreover, these results were also achieved in female patients receiving anthracycline plus cyclophosphamide-based chemotherapy. NEPA represents a real step forward in the prophylaxis of CINV.
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Affiliation(s)
- Vito Lorusso
- National Cancer Research Centre, Istituto Tumori Giovanni Paolo II, Bari, Italy
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Chasen MR, Rapoport BL. Rolapitant for the treatment of chemotherapy-induced nausea and vomiting: a review of the clinical evidence. Future Oncol 2016; 12:763-78. [DOI: 10.2217/fon.16.11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chemotherapy-induced nausea and vomiting (CINV), both acute and delayed, has a dramatic effect on the well-being and quality of life of patients with cancer. Improved understanding of the mechanisms involved in CINV has led to the development of agents targeting the 5-HT3 receptor as well as the NK-1 receptor. Antiemetic prophylaxis given to patients receiving highly emetogenic chemotherapy combines agents blocking the 5-HT3 and NK-1 receptors along with corticosteroids given regularly and repeatedly. Rolapitant is a long-acting NK-1 receptor antagonist with proven efficacy in controlling CINV as part of the prophylaxis regimen. This review will detail the clinical efficacy and safety of rolapitant in the treatment of patients with cancer receiving highly or moderately emetogenic chemotherapy.
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Affiliation(s)
- Martin R Chasen
- Palliative Care, Ottawa Hospital Cancer Centre, Ottawa, Canada
- Palliative Rehabilitation Program, Élisabeth Bruyère Hospital, Ottawa, Canada
| | - Bernardo L Rapoport
- The Medical Oncology Centre of Rosebank, Saxonwold, Johannesburg, South Africa
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Tsuda T, Kyomori C, Mizukami T, Taniyama T, Izawa N, Horie Y, Hirakawa M, Ogura T, Nakajima TE, Tsugawa K, Boku N. Infusion site adverse events in breast cancer patients receiving highly emetic chemotherapy with prophylactic anti-emetic treatment with aprepitant and fosaprepitant: A retrospective comparison. Mol Clin Oncol 2016; 4:603-606. [PMID: 27073673 DOI: 10.3892/mco.2016.769] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/18/2016] [Indexed: 11/06/2022] Open
Abstract
The incidences of infusion site adverse events in chemotherapy regimens, including anthracyclines with either fosaprepitant or aprepitant as the anti-emetic, were not highlighted in the randomized trial comparing aprepitant and fosaprepitant. The present retrospective analysis was performed in breast cancer patients receiving anthracycline-containing chemotherapy, a combination of epirubicin and cyclophosphamide with or without 5-fluorouracil as the adjuvant or neoadjuvant, at the outpatient infusion center of St. Marianna University Hospital (Kawasaki, Japan). Infusion site adverse events were retrospectively compared between the 3 months prior to and three months following switching from 3 day oral administration of aprepitant to intravenous infusion of fosaprepitant. A total of 62 patients were included in the aprepitant group and 38 in the fosaprepitant group. Of these patients, 26 (42%) in the aprepitant group and 36 patients (96%) in the fosaprepitant group experienced any grade of infusion site adverse events at least once (P<0.001). As an anti-emetic treatment for chemotherapy using anthracyclines, fosaprepitant may be associated with a higher risk of infusion site adverse events compared with aprepitant.
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Affiliation(s)
- Takashi Tsuda
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Chisato Kyomori
- Department of Nursing, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Takuro Mizukami
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Tomoko Taniyama
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Naoki Izawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Yoshiki Horie
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Mami Hirakawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Takashi Ogura
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Takako Eguchi Nakajima
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Koichiro Tsugawa
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Narikazu Boku
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
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36
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Navari RM. The safety of antiemetic medications for the prevention of chemotherapy-induced nausea and vomiting. Expert Opin Drug Saf 2016; 15:343-56. [DOI: 10.1517/14740338.2016.1135899] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Weinstein C, Jordan K, Green SA, Camacho E, Khanani S, Beckford-Brathwaite E, Vallejos W, Liang LW, Noga SJ, Rapoport BL. Single-dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with moderately emetogenic chemotherapy: results of a randomized, double-blind phase III trial. Ann Oncol 2016; 27:172-8. [PMID: 26449391 PMCID: PMC4684151 DOI: 10.1093/annonc/mdv482] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/01/2015] [Accepted: 09/23/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To establish the role of antiemetic therapy with neurokinin-1 (NK1) receptor antagonists (RAs) in nonanthracycline and cyclophosphamide (AC)-based moderately emetogenic chemotherapy (MEC) regimens, this study evaluated single-dose intravenous (i.v.) fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting (CINV) associated with non-AC MEC. PATIENTS AND METHODS In this international, phase III, double-blind trial, adult cancer subjects scheduled to receive ≥1 non-AC MEC on day 1 were randomized to a regimen comprising single-dose i.v. fosaprepitant 150 mg or placebo along with ondansetron and dexamethasone on day 1; control regimen recipients received ondansetron on days 2 and 3. Primary end points were the proportion of subjects achieving a complete response (CR; no vomiting and no use of rescue medication) in the delayed phase (25-120 h after MEC initiation) and safety. Secondary end points included CR in the overall and acute phases (0-120 and 0-24 h after MEC initiation, respectively) and no vomiting in the overall phase. Nausea and the Functional Living Index-Emesis were assessed as exploratory end points. RESULTS The fosaprepitant regimen improved CR significantly in the delayed (78.9% versus 68.5%; P < 0.001) and overall (77.1% versus 66.9%; P < 0.001) phases, but not in the acute phase (93.2% versus 91.0%; P = 0.184), versus control. In the overall phase, the proportion of subjects with no vomiting (82.7% versus 72.9%; P < 0.001) and no significant nausea (83.2% versus 77.9%; P = 0.030) was also significantly improved with the fosaprepitant regimen. The fosaprepitant regimen was generally well tolerated. CONCLUSION Single-dose fosaprepitant added to a 5-HT3 RA and dexamethasone was well tolerated and demonstrated superior control of CINV (primary end point achieved) associated with non-AC MEC. This is the first study to evaluate NK1 RA therapy as an i.v. formulation in a well-defined non-AC MEC population. CLINICALTRIALSGOV NCT01594749 (https://clinicaltrials.gov/ct2/show/NCT01594749).
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Affiliation(s)
| | - K Jordan
- Department of Hematology/Oncology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - S A Green
- Merck & Co., Inc., Kenilworth, NJ, USA
| | - E Camacho
- Department of Hematology and Medical Oncology, Comprehensive Cancer Center at the Desert Regional Medical Center, Palm Springs, CA
| | - S Khanani
- Department of Hematology/Oncology, Reliant Medical Group, Worcester, MA
| | | | | | - L W Liang
- Merck & Co., Inc., Kenilworth, NJ, USA
| | - S J Noga
- Department of Oncology, Weinberg Cancer Institute, Baltimore, MD, USA
| | - B L Rapoport
- Department of Medical Oncology, Medical Oncology Center of Rosebank, Johannesburg, South Africa
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Aapro M, Carides A, Rapoport BL, Schmoll HJ, Zhang L, Warr D. Aprepitant and fosaprepitant: a 10-year review of efficacy and safety. Oncologist 2015; 20:450-8. [PMID: 25795636 DOI: 10.1634/theoncologist.2014-0229] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 01/23/2015] [Indexed: 11/17/2022] Open
Abstract
Chemotherapy-induced nausea and vomiting (CINV) is a common adverse event associated with anticancer treatment that can have a significant adverse impact on patient health-related quality of life and that can potentially undermine the effectiveness of chemotherapy. Traditional regimens to prevent CINV generally involved a combination of a corticosteroid plus a 5-hydroxytryptamine (5HT3) receptor antagonist (RA). In the past 10 years, antiemetic treatment has greatly advanced with the availability of the neurokinin-1 receptor antagonist (NK1 RA) aprepitant and its prodrug fosaprepitant. NK1 RAs have a different mechanism of action in CINV than corticosteroids and 5HT3 RAs, thus their use can complement traditional antiemetic drugs and can enhance control of CINV. This review examined accumulated data regarding the safety and efficacy of aprepitant and fosaprepitant over the decade since the first regulatory approval. Data from key studies of aprepitant and fosaprepitant in the prevention of CINV in patients receiving moderately and highly emetogenic chemotherapy were explored, as were recommendations in currently available guidelines for their use. In addition, their use as antiemetic therapy in special patient populations was highlighted. Future perspectives on potential uses of aprepitant and fosaprepitant for indications other than CINV are presented.
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Affiliation(s)
- Matti Aapro
- Clinique de Genolier, Genolier, Switzerland; Temple University, Philadelphia, Pennsylvania, USA; The Medical Oncology Center of Rosebank, Johannesburg, South Africa; University Clinic Halle, Halle, Germany; Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China; Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Alexandra Carides
- Clinique de Genolier, Genolier, Switzerland; Temple University, Philadelphia, Pennsylvania, USA; The Medical Oncology Center of Rosebank, Johannesburg, South Africa; University Clinic Halle, Halle, Germany; Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China; Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Bernardo L Rapoport
- Clinique de Genolier, Genolier, Switzerland; Temple University, Philadelphia, Pennsylvania, USA; The Medical Oncology Center of Rosebank, Johannesburg, South Africa; University Clinic Halle, Halle, Germany; Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China; Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Hans-Joachim Schmoll
- Clinique de Genolier, Genolier, Switzerland; Temple University, Philadelphia, Pennsylvania, USA; The Medical Oncology Center of Rosebank, Johannesburg, South Africa; University Clinic Halle, Halle, Germany; Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China; Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Li Zhang
- Clinique de Genolier, Genolier, Switzerland; Temple University, Philadelphia, Pennsylvania, USA; The Medical Oncology Center of Rosebank, Johannesburg, South Africa; University Clinic Halle, Halle, Germany; Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China; Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - David Warr
- Clinique de Genolier, Genolier, Switzerland; Temple University, Philadelphia, Pennsylvania, USA; The Medical Oncology Center of Rosebank, Johannesburg, South Africa; University Clinic Halle, Halle, Germany; Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China; Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Lorusso V, Karthaus M, Aapro M. Review of oral fixed-dose combination netupitant and palonosetron (NEPA) for the treatment of chemotherapy-induced nausea and vomiting. Future Oncol 2014; 11:565-77. [PMID: 25360998 DOI: 10.2217/fon.14.260] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Current guidelines recommend the combination of a neurokinin-1 (NK1) receptor antagonist (RA) and a 5-hydroxytryptamine-3 (5-HT3) RA, together with corticosteroids, in order to prevent chemotherapy-induced nausea and vomiting with anthracycline-cyclophosphamide and highly emetogenic chemotherapy, and it is to be considered with moderately emetogenic chemotherapy. Netupitant and palonosetron (NEPA) is a fixed-dose combination of netupitant, a novel, highly selective NK1 RA, and palonosetron, a new-generation 5-HT3 RA, targeting two major emetic pathways in a single oral capsule. In clinical trials, NEPA administered on day 1 together with dexamethasone was highly effective and well tolerated in the prevention of chemotherapy-induced nausea and vomiting in patients with solid tumors undergoing moderately emetogenic chemotherapy or highly emetogenic chemotherapy. NEPA offers maximal convenience, and as a simple guideline-based regimen, has the potential to improve adherence to guidelines.
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Affiliation(s)
- Vito Lorusso
- Medical Oncology Unit, National Cancer Institute Giovanni Paolo II, 70124 Bari, Italy
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An analysis of fosaprepitant-induced venous toxicity in patients receiving highly emetogenic chemotherapy. Support Care Cancer 2014; 23:55-9. [PMID: 24964876 DOI: 10.1007/s00520-014-2326-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 06/16/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Fosaprepitant is an antiemetic used for chemotherapy-induced nausea and vomiting. We recently reported increased infusion site adverse events (ISAE) in a cohort of breast cancer patients receiving chemotherapy with doxorubicin and cyclophosphamide (AC). In this current study, we evaluated the venous toxicity of fosaprepitant use with non-anthracycline platinum-based antineoplastic regimens. METHODS A retrospective review was conducted of the first 81 patients initiated on fosaprepitant among patients receiving highly emetogenic chemotherapy, on or after January 1, 2011 at Mayo Clinic Rochester. None of these regimens included an anthracycline. Data collected included baseline demographics, chemotherapy regimen, type of intravenous access and type, and severity of ISAE. Data from these patients were compared to previously collected data from patients who had received AC. Statistical analysis using χ 2 and univariate logistic regression was used to evaluate the association between treatment regimen, fosaprepitant, and risk of ISAE. RESULTS Among these 81 patients, the incidence of ISAE was 7.4% in the non-anthracycline platinum group. The most commonly reported ISAE were swelling (3%), extravasation (3%), and phlebitis (3%). When stratified by regimen, fosaprepitant was associated with a statistically significant increased risk of ISAE in the anthracycline group (OR 8.1; 95% CI 2.0-31.9) compared to the platinum group. CONCLUSIONS Fosaprepitant antiemetic therapy causes significant ISAE that are appreciably higher than previous reports. Patients receiving platinum-based chemotherapy appear to have less significant ISAE than do patients who receive anthracycline-based regimens.
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