1579P - The efficacy of triplet antiemetic therapy for chemotherapy-induced nausea and vomiting in lung cancer patients receiving highly emetogenic chemothe...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Supportive measures
Thoracic malignancies
Presenter Hirohisa Yoshizawa
Authors H. Yoshizawa1, K. Sato2, M. Makino3, O. Kobayashi4, H. Tanaka5, S. Miura6, S. Watanabe1, J. Tanaka7, H. Kagamu6, N. Ichiei6
  • 1Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, 951-8520 - Niigata/JP
  • 2Department Of Respiratory Medicine, Nagaoka Red Cross Hospital, Nagaoka/JP
  • 3Department Of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata/JP
  • 4Department Of Internal Medicine, Niigata Prefectural Central Hospital, Jyoetsu/JP
  • 5Department Of Internal Medicine, Niigata Cancer Center Hospital, Niigata/JP
  • 6Department Of Medicine (ii), Niigata University Medical and Dental Hospital, Niigata/JP
  • 7Department Of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata/JP



Chemotherapy-induced nausea and vomiting (CINV) is one of the most problematic symptoms experienced by patients undergoing cancer treatments. Triplet therapy with PALO, APR, and DEX, is a guideline-recommended antiemetic prophylaxis for highly emetogenic chemotherapy (HEC). However, the efficacy and safety of this therapy for lung cancer patients has not yet been well investigated.


Chemotherapy naïve lung cancer patients scheduled to receive HEC were enrolled in this study. The eligible patients were pretreated with the triplet therapy (PALO 0.75 mg day 1, APR 125 mg day 1 and 80 mg day 2-3, DEX 9.9 mg day 1 and 8 mg day 2-4) before receiving HEC. The efficacy and safety of these substances were assessed during an observation period starting from the administration of HEC to 120 hours. A questionnaire diary documented patients' complaints. The primary endpoint was the proportion of the patients who did not experience emesis or rescue antiemetic (Complete Response rate; CR rate) during any part of the whole observation period. The secondary endpoints were (1) the CR rate during the acute phase (0-24hrs) and the late phase (24-120hrs), (2) the proportion of patients who experienced no emetic episodes and significant nausea with no rescue medication (Complete Control rate; CC rate), and (3) safety.


A total of 72 patients were enrolled with 65 assessable patients at the time of submission. The median age was 64 years. The CR rate during the whole observation period, the acute and late phase was 78.5 %, 95.4% and 80.0%, respectively. The CC rate in the late phase was 62.9%. No severe side effects were observed. In the subset analysis, the CC rate in late phase was significantly lower in female subset (71.4% vs. 45.0%). Another subset analysis regarding to chemotherapy regimen, the proportion of vomiting event was higher in the pemetrexed used regimen.


Triplet therapy using PALO, APR and DEX, was shown to be safe and effective in preventing CINV in lung cancer patients treated with HEC. Further investigation is needed for to reduce nausea in the late phase.


All authors have declared no conflicts of interest.