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Cancer Resources > Cancer News > 2009 > November

Casopitant helps curb chemotherapy emesis

David Douglas

Last Updated: 2009-11-12 14:15:27 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Casopitant in combination with ondansetron and dexamethasone can help prevent chemotherapy-induced nausea and vomiting.

"Our studies on casopitant," senior investigator Dr. Stephen M. Grunberg told Reuters Health, "confirm the activity of the neurokinin-1 (NK-1) receptor antagonists against acute and delayed chemotherapy-induced emesis."

In an October 15th on-line publication in Cancer, Dr. Grunberg of the University of Vermont, Burlington and colleagues report on their phase 2 trial results in 723 chemotherapy naive patients who went on to receive moderately emetogenic treatment.

They were randomized to oral placebo or the NK-1 antagonist casopitant at doses of 50, 100, or 150 mg daily on days 1 to 3 along with ondansetron on days 1 to 3 and dexamethasone on day 1.

The team then evaluated single-dose casopitant (150 mg) plus ondansetron and dexamethasone and compared it with a 3-day casopitant regimen with once-daily ondansetron and dexamethasone.

All casopitant doses significantly increased the proportion of patients with a complete response, defined as no vomiting, retching, rescue therapy, or premature discontinuation.

These rates were 80.8% with casopitant 50 mg, 78.5% with casopitant 100 mg, and 84.2% with casopitant 150 mg. The corresponding proportion in controls was 69.4%.

Casopitant 150 mg was identified as the minimally effective dose. Exploratory analyses showed that single-dose casopitant gave a 79.2% complete remission rate, and once-daily ondansetron plus casopitant produced an 83.5% rate.

Vomiting rates in the first 5 days after chemotherapy were reduced from 23% to as little as 10% with casopitant-containing regimens.

The rates of significant nausea (28% to 29%) did not differ across treatment groups.

"Our studies on casopitant," concluded Dr. Grunberg, "confirm the activity of the NK-1 antagonists against acute and delayed chemotherapy-induced emesis."

"Successful use of a single dose of an NK-1 antagonist as part of an antiemetic regimen in preventing acute and delayed emesis," he concluded, "simplifies these regimens and demonstrates that prevention of emesis can be achieved through appropriate early intervention."

Cancer 2009.

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