Discussion
emesis, nausea, vomiting
ONCOLOGY, SECONDARY
The current study failed to demonstrate non-inferiority, in terms of nausea control, when the NK-1 receptor antagonist was not used in combination with olanzapine, a 5-HTA secondary endpoint in the current trial regarding complete responses (ie, no vomiting and no use of additional antiemetics) also supports that the NK-1 receptor antagonist component of the 4-drug regimen provides a small benefit in the delayed period. This finding is consistent with the demonstrated benefit of NK-1 receptor antagonists for the prevention of emesis in the delayed period postchemotherapy. There was no suggestion of any difference in complete responses between the 2 regimens during the one-day acute period postchemotherapy.The data demonstrate that fosaprepitant may cause some increased sedation, supporting that 2 of the 4 drugs in this antiemetic regimen (olanzapine and fosaprepitant) cause some sedation.The Alliance for Clinical Trials in Oncology has now conducted 2 randomized, double-blind, placebo-controlled trials that have studied the 4-drug antiemetic regimen that was used in the current trial. While the current trial took away the NK-1 receptor antagonist from the 4-arm regimen, our previously reported trial took away olanzapine from this 4-arm regimen.
Comparison of daily nausea scores by arm in the 2 arms of the current trial and 2 arms of a previous trial.