Platinum-based agents are key chemotherapeutic drugs for lung cancer patients. Although considerable progress has been made in supportive therapy for chemotherapy-induced nausea and vomiting (CINV), its preventive effect for delayed-onset CINV has not been always satisfactory. We aimed to evaluate whether rikkunshito (RKT), a traditional herbal medicine of Japan, improves CINV-induced anorexia and increases plasma acylated ghrelin (AG) levels, an orexigenic gut hormone known to alleviate CINV, in lung cancer patients receiving chemotherapy.
From July 2013 to March 2016, 40 lung cancer patients undergoing cisplatin-based chemotherapy were enrolled and randomized to group A (1st course with RKT (7.5 g/day on days 1-14), 2nd course without RKT (control)) or group B (1st course without RKT (control), 2nd course with RKT) in a prospective crossover study. All patients were administered cisplatin on day 1 and treated with 5HT3 and NK1 receptor antagonists and steroids throughout the study. Mean food intake during 1st and 2nd courses from days 3 to 5 were compared with baseline food intake (day 1). Fasting blood samples were obtained on days 1, 3 and 5, and plasma AG levels (fmol/mL) were measured by enzyme-linked immunosorbent assay methods. The primary endpoint was food intake and secondary endpoint was plasma AG levels.
Thirty-nine patients (male/female, 35/4; median age, 67 years) were included in the analysis. A decreasing rate of the food intake in the control course was significantly higher than that in the RKT course (control, 25%; RKT, 18%; p = 0.025). A significant drop in plasma AG levels from day 1 to day 3 was initially noted (RKT, 11.9, 7.3, p
RKT administration improves delayed-onset CINV-induced anorexia and increases plasma AG levels in lung cancer patients undergoing highly emetogenic chemotherapy.
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All authors have declared no conflicts of interest.