Comparison of the efficacy and the safety of metoclopramide versus aprepitant in the prevention of delayed chemotherapy-induced nausea and vomiting in patients with highly emetogenic chemotherapies: a prospective randomized-controlled trial
WANG Hui
ZHENG Ji-hua
XIE Bo
XU Zhi-yong
LUO Wen-biao
HUANG Xue-qin
WANG Xian-ci
CHENG Dong-hai
WEN Ying-juan
WANG Wu-jun
ZHANG Wei-min
Abstract：Objective To compare the efficacy and safety between metoclopramide and aprepitant when combined with dexamethasone for prophylaxis of delayed chemotherapy-induced nausea and vomiting (CINV) in patients with highly emetogenic chemotherapy (HEC).Methods Patients with malignant solid tumor, who would receive HEC, were randomly assigned to either metoclopramide (MPD) group or aprepitant (APD) group.MPD group received a combination of metoclopramide (20 mg bid d2-4), palonosetron (0.25 mg d1) and dexamethasone (20 mg d1, 8 mg bid d2-4);and APD group received aprepitant (125 mg d1, 80 mg d2-3), palonosetron (0.25 mg d1) and dexamethasone (12 mg d1, 8 mg qd d2-4) for emesis control.The primary end point was complete response (defined as no vomiting and no rescue medication, CR) at the delayed period (24-120 h after the start of chemotherapy), and secondary end point was the incidence of side-effects.Results Thirty patients were enrolled in the MPD group and 31 enrolled in the APD group.All patients were evaluable.No significant difference was found between MPD group and APD group in the CR rate of delayed CINV (83.3% vs.80.6%, P>0.05).The most common adverse events were constipation, fatigue and hiccups, and all adverse reactions were tolerable.No significant difference was found in side effects (P>0.05).Conclusion The triple antiemetic therapy with metoclopramide, palonosetron, and dexamethasone shows similar efficacy and safety with the standard triple antiemetic therapy of aprepitant, palonosetron, and dexamethasone in HEC.
Keywords：metoclopramideaprepitanthighly emetogenic chemotherapyDelayed CINV
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1421-1424,1428 )