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Reducing Nausea and Vomiting from Chemotherapy
There may be a new drug to combat the nausea people undergoing bone marrow transplants experience in the course of treatment. The drug, called aprepitant, received FDA approval in 2003. Yet it has rarely been studied in or given to bone marrow transplant recipients, who receive very high doses of chemotherapy agents, as well as radiation treatments.
Bone marrow transplant patients say that nausea and vomiting are the second worst side effects of the treatment. Patients may throw up 3-5 times daily for a week or longer. The only things they find worse are the throat and mouth sores that accompany the transplant.
Most anti-nausea/vomiting drugs work by blocking signals from the stomach. Aprepitant works by blocking signals from the brain. When the two types of drugs are combined, they can be much more effective than when given individually.
The Loyola University Health System study compared the combination of aprepitant and a standard drug to the standard drug alone. Seventy-three percent (73%) of the patients who received aprepitant reported no vomiting during the study period, compared with 23% who only received the standard drug. And 49% of the aprepitant patients reported no vomiting and little or no nausea, compared with 15% of the patients receiving only the standard drug.
The study was of 179 patients, half of whom received aprepitant. It was a Phase III, blinded, prospective study.
Bone marrow transplants are used to treat cancerous diseases such as leukemia and Hodgkin's disease, as well as for some non-cancerous conditions such as sickle cell anemia. Bone marrow transplant patients require high doses of chemotherapy agents, doses that are even higher than those given to most cancer patients.
The researchers now believe that aprepitant should become a standard treatment for bone marrow transplant recipients. And its effectiveness in the study will likely lead to a broader general usage of aprepitant.
The study was presented at the 2010 BMT Tandem Meetings in Orlando, Florida. It received a Best Abstract Award from the Center for International Blood & Marrow Transplant Research, one of the meetings' sponsors.
April 11, 2010
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