ISSUE 1561
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The FDA has approved Cinvanti (Heron), an IV emulsion formulation of the substance P/neurokinin-1 (NK1) receptor antagonist aprepitant, for prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) in adults. Aprepitant is also available in oral capsule and suspension formulations (Emend, and generics), and fosaprepitant, a prodrug of aprepitant, is available in an IV formulation (Emend for injection).
STANDARD TREATMENT — Patients receiving moderately emetogenic chemotherapy are generally treated with dexamethasone (Decadron, and generics) and a 5-HT3 receptor antagonist such as palonosetron (Aloxi, and generics) for prevention of CINV; those receiving carboplatin-based chemotherapy should also receive a substance P/NK1 receptor antagonist (see Table 1). Most patients treated with
... more- PJ Hesketh et al. Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2017; 35:3240.
- T Ottoboni et al. Bioequivalence of HTX-019 (aprepitant IV) and fosaprepitant in healthy subjects: a phase I, open-label, randomized, two-way crossover evaluation. Drug Des Devel Ther 2018; 12:429.
- T Ottoboni et al. Safety of HTX-019 (intravenous aprepitant) and fosaprepitant in healthy subjects. Future Oncol 2018; 14:2849.
- Inhibitors and inducers of CYP enzymes and P-glycoprotein. Med Lett Drugs Ther 2017 September 18 (epub). Available at: www.medicalletter.org/downloads/CYP_PGP_Tables.pdf.
- MJ Berger et al. NCCN guidelines insights: antiemesis, version 2.2017. J Natl Compr Canc Netw 2017; 15:883.
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