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A new drug helps reduce nausea and vomiting associated with chemotherapy,
according to the U.S. Food and Drug Administration (FDA) who approved aprepitant (brand
name, Emend) in March 2003 for use in combination with other anti-nausea drugs. The
approval came after research showed that aprepitant significantly reduced immediate and
delayed nausea and vomiting (up to five days) in patients who received a strong form of
chemotherapy.
Because chemotherapy is a systemic treatment—affecting the entire body, both
normal and cancerous cells—side effects are possible. These side effects vary
significantly depending on several factors, including the types of drugs used, their
dosages, and the duration of treatment. For example, some chemotherapy drugs may irritate
the lining of the stomach or intestines. Drugs that may be more likely to cause nausea or
vomiting include cisplatin, cyclophosphamide, doxorubicin, etoposide (high doses), etc.
Sometimes, nausea and vomiting occur within a few minutes of or after treatment. At times,
patients may experience "anticipatory" nausea, in which symptoms develop before
a treatment due to psychological associations. Other common side effects of chemotherapy
include hair loss (alopecia) and fatigue.
In a recent issue of the journal, Cancer, Sergio Poli-Bigelli, MD of the
Instituto de Oncologia Hematologia at the Universidad Central de Venezuela and colleagues
from Brazil and Pennsylvania added the drug aprepitant to other commonly used anti-nausea
treatments (ondansetron and dexamethasone) to determine whether aprepitant could further
reduce nausea and vomiting resulting from chemotherapy with drugs such as cisplatin. The
study was funded by Merck, the maker of aprepitant.
Two hundred eighty-six chemotherapy patients were given standard anti-nausea drugs
during chemotherapy while 283 patients received aprepitant in addition to the standard
drugs. The results of the study showed that 47% of patients on aprepitant experienced
vomiting and 37% experienced nausea within five days of treatment. This is compared to
patients in the group who received only the standard anti-nausea drugs: 57% of those
patients experienced vomiting and 60% experienced nausea.
"Nausea and vomiting are two common complications of cancer chemotherapy and can
lead to considerable distress and disruption in patients' lives," said Scott Reines,
MD., PhD, Vice President, Clinical Research, Merck Research Laboratories, in a company
news release. "Emend [generic name, aprepitant] is a new medicine that will help more
patients to avoid symptoms of nausea and vomiting for up to five days after their
chemotherapy treatment."
Aprepitant is the first medicine that is FDA approved to treat delayed symptoms of
nausea. Sometimes, nausea and vomiting can begin after the first day of chemotherapy and
last for several days after treatment. Patients take aprepitant once a day for three days.
The drug is not approved to be taken continuously since its effect can change.
Despite the side effects that can occur with chemotherapy, it can be highly effective
at treating cancer or reducing the risk that cancer will recur in the future. Furthermore,
most of these side effects are temporary and go away after treatment is completed. In most
cases, the benefits of treating cancer with chemotherapy far outweighs the risks or
inconveniences of any side effects.
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