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Evaluation of aprepitant and fosaprepitant in pediatric patients

Yoshimasa Saito1, Tadashi Kumamoto2, Takamichi Arima1

  • 1Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|January 8, 2019
PubMed

Insights

Aprepitant and fosaprepitant show similar efficacy and safety in preventing chemotherapy-induced nausea and vomiting (CINV) in pediatric patients. Complete response rates were comparable between the two neurokinin-1 receptor antagonists.

Area of Science:

  • Oncology
  • Pharmacology
  • Pediatrics

Background:

  • Chemotherapy-induced nausea and vomiting (CINV) is a significant challenge in pediatric cancer care.
  • Neurokinin-1 receptor antagonists, such as aprepitant and fosaprepitant, are crucial in CINV management.
  • While effective in adults, fosaprepitant's efficacy in pediatric patients compared to aprepitant required investigation.

Purpose of the Study:

  • To compare the efficacy and safety of aprepitant versus fosaprepitant in pediatric patients undergoing chemotherapy.
  • To evaluate complete response (CR) rates and identify potential risk factors for CINV in children.

Main Methods:

  • A retrospective study included pediatric patients (<18 years) receiving aprepitant or fosaprepitant for CINV from 2015-2018.
  • The primary endpoint was CR (no vomiting/rescue medication) within 120 hours post-chemotherapy.
  • Safety was assessed by severe adverse events, and age and sex were analyzed as risk factors.

Main Results:

  • A total of 125 chemotherapy cycles were analyzed.
  • Complete response rates were similar: 45.0% for aprepitant and 42.2% for fosaprepitant (P=0.852).
  • No severe adverse events were reported; age (6-14 years) was associated with lower CR rates.

Conclusions:

  • Aprepitant and fosaprepitant are safe and equally effective for pediatric CINV prevention.
  • Patient age may influence the effectiveness of these neurokinin-1 receptor antagonists.
  • Further research into age-related efficacy is warranted.
Abstract

Keywords:
aprepitantchemotherapy-induced nausea and vomitingfosaprepitantpediatricsupportive care

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