NEPA efficacy and tolerability during (neo)adjuvant breast cancer chemotherapy with cyclophosphamide and doxorubicin.

Winnie Yeo, Thomas Kh Lau, Carol Ch Kwok, Kwai T Lai, Vicky Tc Chan, Leung Li, Vivian Chan, Ashley Wong, Winnie Mt Soo, Eva Wm Yeung, Kam H Wong, Nelson Ls Tang, Joyce Js Suen, Frankie Kf Mo

BMJ supportive & palliative care 2022 Jul

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This is a prospective study evaluating NEPA in patients with breast cancer (the NEPA group), who received (neo)adjuvant AC chemotherapy (consisting of doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2). The primary objectives were to assess the efficacy and safety of NEPA in controlling chemotherapy-induced nausea and vomiting (CINV). The secondary objectives were to compare CINV between the NEPA group and historical controls (the APR group) who received aprepitant in an earlier prospective randomised study. 60 patients participated in the NEPA group; 62 were in the APR group. Eligibility criteria of both groups were similar, that is, Chinese patients with breast cancer who were treated with (neo)adjuvant AC. NEPA group received NEPA and dexamethasone; APR group received aprepitant, ondansetron and dexamethasone. Individuals filled in self-reported diary, visual analogue scale for nausea and Functional Living Index-Emesis questionnaire. Within the NEPA group, 70.0%, 85.7% and 60.0%, respectively reported complete response in the acute, delayed and overall phases in cycle 1 AC. When compared with the historical APR group during cycle 1 AC, NEPA group achieved significantly higher rates of complete response, complete protection, total control, 'no significant nausea' and 'no nausea' in the delayed phase; similar findings were noted in the overall phase with significantly better quality of life. Superior efficacy of NEPA was maintained over multiple cycles. Both antiemetic regimens were well tolerated. In this study on Chinese patients with breast cancer who were uniformly receiving AC, NEPA was effective in controlling CINV. NCT03386617. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Winnie Yeo, Thomas Kh Lau, Carol Ch Kwok, Kwai T Lai, Vicky Tc Chan, Leung Li, Vivian Chan, Ashley Wong, Winnie Mt Soo, Eva Wm Yeung, Kam H Wong, Nelson Ls Tang, Joyce Js Suen, Frankie Kf Mo. NEPA efficacy and tolerability during (neo)adjuvant breast cancer chemotherapy with cyclophosphamide and doxorubicin. BMJ supportive & palliative care. 2022 Jul;12(e2):e264-e270