Abstract 584P
Background
Chemotherapy induced nausea and vomiting (CINV) remains important and distressing adverse effect in patients receiving high dose chemotherapy as conditioning regimen for Autologous Stem Cell Transplantation (Auto-SCT) . Failure to appreciate scope of this issue and implement effective anti-emetic regimen contributes to poorer compliance and treatment outcomes. This study determines the effectiveness of single agent NEPA & fosaprepitant in patients undergoing Auto-SCT at our center.
Methods
Materials and methods – This prospective study includes eligible cases of Multiple myeloma (MM), relapsed Hodgkin’s lymphoma (HL) and Non Hodgkins Lymphoma (NHL) who underwent Auto-SCT from June -2022 to June – 2024. Patients were randomized by block randomization method to receive single agent NEPA and fosaprepitant as anti-emetic prophylaxis before administering high dose conditioning regimens. Responses were recorded using standard visual analogue scale during acute (<24hrs), delayed (24–120 hrs) and overall (0-120 hrs) phases.
Results
We enrolled 40 patients, median age 38 yrs (range : 18—59) all with diagnosis of MM (n=31), Relapsed HL(n=8) and NHL (n=1). As part of conditioning regimen, high dose melphalan and BEAM regimen were used in 31 and 9 patients respectively. The complete response rates in acute phase (CR-AP) was 65.0 % and 66.7 % while complete response rates in delayed phase (CR- DP) was 45.7% and 55.6% in fosaprepitant and NEPA arms respectively. The overall complete response (CR-O) was also higher in NEPA arm (77.8 % vs 60%).
Conclusions
Single agent oral NEPA is more effective in preventing CINV in acute, delayed, overall phases in patients receiving high dose chemotherapy as conditioning regimen for Auto-SCT. Keywords - NEPA, fosaprepitant, Auto-SCT, chemotherapy induced nausea and vomiting, complete response.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Kidwai Memorial Institute of Oncology.
Funding
Kidwai Memorial Institute of Oncology.
Disclosure
The author has declared no conflicts of interest.