Comparison of NEPA-based versus olanzapine/aprepitantbased antiemetic regimen for Chinese breast cancer patients
undergoing highly emetogenic chemotherapy
Invited conference paper presented and published in conference proceedings

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Chemotherapy-induced nausea and vomiting (CINV) is a major concern for patients receiving highly emetogenic doxorubicin and cyclophosphamide (AC) chemotherapy. Recommended antiemetic regimens incorporate neurokinin-1 receptor antagonist, 5-hydroxytryptamine type-3 receptor antagonist, corticosteroid and dopamine antagonist. The present post-hoc analyses compared 2 treatment groups of patients who were enrolled into two recently reported prospective antiemetic studies. The objectives were to compare the effectiveness of emesis control using olanzapine- versus NEPA-containing antiemetic regimens in the first cycle of AC.
Data from 120 Chinese breast cancer patients who underwent AC were included in this analysis. They were categorized into olanzapine group (aprepitant/ondansetron/dexamethasone/olanzapine) and NEPA group (NEPA [consisted of netupitant/palonosetron]/dexamethasone). Individuals filled in self-reported diaries that recorded CINV and the functional living index – emesis (FLIE) questionnaire for quality of life (QOL) assessment.
During cycle 1 AC, there were no differences in complete response, complete protection and total control between the 2 groups. In the acute phase, the only significant finding was a higher rate of ‘no use of rescue therapy' in the olanzapine group (olanzapine vs NEPA: 96.7% vs 85%, p = 0.0225). In the delayed phase, no differences were found for all studied parameters. In the overall phase, there were significantly higher rates of 'no use of rescue therapy' (91.7% vs 78.6%, p = 0.0244) as well as 'no significant nausea' (91.7% vs 78.3%, p = 0.0408) in the olanzapine group. There were no significant differences in QOL between the 2 groups.
The results support olanzapine may be more efficacious for control of nausea. However, this analysis cannot conclusively support the superiority of either the olanzapine-based regimen or the NEPA-based regimen in terms of antiemetic efficacy or quality of life in a clinical setting of breast cancer patients who were undergoing AC.
Acceptance Date20/11/2020
All Author(s) ListW Yeo, CC Yip, TK Lau, KT Lai, VT Chan, L Li, E Pang, M Cheung, CC Kwok, W Y Chan, FK Mo
Name of ConferenceESMO Asia Virtual Congress 2020
Start Date of Conference20/11/2020
End Date of Conference22/11/2020
Place of ConferenceVirtual
Country/Region of ConferenceSingapore
Proceedings TitleAnnals of Oncology
Series TitleAnnals of Oncology
Volume Number31
Issue NumberSuppl 6
Place of PublicationSingapore
PagesS1371 - S1371
LanguagesEnglish-United Kingdom

Last updated on 2022-10-01 at 23:30