Antiemetic effectiveness and cost-saving of aprepitant plus granisetron is superior to palonosetron in gastrointestinal cancer patients who received moderately emetogenic chemotherapy

Haruka Toda, Hitoshi Kawazoe, Akiko Yano, Yuji Yamamoto, Yuji Watanabe, Yasunori Yamamoto, Yoichi Hiasa, Yoshihiro Yakushijin, Akihiro Tanaka, Hiroaki Araki

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose The therapeutic benefit of a three-drug combination of antiemetics has not been established in moderately emetogenic chemotherapy (MEC). The aim of this study was to compare the antiemetic effectiveness and cost-saving of palonosetron plus dexamethasone (control group) with aprepitant, granisetron, and dexamethasone (study group) in cancer patients who received MEC. Methods We switched the standard antiemetic treatment from the control group to the study group in gastrointestinal cancer patients who received MEC after October 2015. The antiemetics in both groups were modified using salvage antiemetic therapy at the clinicians' discretion, according to the severity of chemotherapy-induced nausea and vomiting. We retrospectively reviewed the electronic medical records from patients, before and after switching groups, from between April 2014 and March 2016. Results We evaluated 443 treatment courses in 83 patients. The proportion of courses that included salvage antiemetic therapy in the control group and the study group was 34.8 % (116/333) and 8.2 % (9/110), respectively, and was statistically significant (p < 0.001). The mean integrated costs of antiemetics per course in the control group and the study group were 193 ± 55 USD and 143 ± 38 USD, respectively. Multivariate logistic regression analysis revealed that the study group was significantly associated with a reduced risk of requiring salvage antiemetic therapy (p = 0.038). Conclusions These results suggest that the antiemetic effectiveness and cost-saving of a three-drug combination of aprepitant, generic granisetron, and dexamethasone was superior to a two-drug combination of palonosetron plus dexamethasone in gastrointestinal cancer patients who received MEC.

Original languageEnglish
Pages (from-to)1371-1377
Number of pages7
JournalJournal of Cancer
Volume8
Issue number8
DOIs
Publication statusPublished - 2017 Jan 1
Externally publishedYes

Fingerprint

aprepitant
Granisetron
Gastrointestinal Neoplasms
Antiemetics
Cost-Benefit Analysis
Drug Therapy
Salvage Therapy
Dexamethasone
Drug Combinations
Control Groups
palonosetron
Electronic Health Records

Keywords

  • Aprepitant
  • Cost-saving
  • Gastrointestinal cancer
  • Moderately emetogenic chemotherapy
  • Palonosetron

ASJC Scopus subject areas

  • Oncology

Cite this

Antiemetic effectiveness and cost-saving of aprepitant plus granisetron is superior to palonosetron in gastrointestinal cancer patients who received moderately emetogenic chemotherapy. / Toda, Haruka; Kawazoe, Hitoshi; Yano, Akiko; Yamamoto, Yuji; Watanabe, Yuji; Yamamoto, Yasunori; Hiasa, Yoichi; Yakushijin, Yoshihiro; Tanaka, Akihiro; Araki, Hiroaki.

In: Journal of Cancer, Vol. 8, No. 8, 01.01.2017, p. 1371-1377.

Research output: Contribution to journalArticle

Toda, Haruka ; Kawazoe, Hitoshi ; Yano, Akiko ; Yamamoto, Yuji ; Watanabe, Yuji ; Yamamoto, Yasunori ; Hiasa, Yoichi ; Yakushijin, Yoshihiro ; Tanaka, Akihiro ; Araki, Hiroaki. / Antiemetic effectiveness and cost-saving of aprepitant plus granisetron is superior to palonosetron in gastrointestinal cancer patients who received moderately emetogenic chemotherapy. In: Journal of Cancer. 2017 ; Vol. 8, No. 8. pp. 1371-1377.
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abstract = "Purpose The therapeutic benefit of a three-drug combination of antiemetics has not been established in moderately emetogenic chemotherapy (MEC). The aim of this study was to compare the antiemetic effectiveness and cost-saving of palonosetron plus dexamethasone (control group) with aprepitant, granisetron, and dexamethasone (study group) in cancer patients who received MEC. Methods We switched the standard antiemetic treatment from the control group to the study group in gastrointestinal cancer patients who received MEC after October 2015. The antiemetics in both groups were modified using salvage antiemetic therapy at the clinicians' discretion, according to the severity of chemotherapy-induced nausea and vomiting. We retrospectively reviewed the electronic medical records from patients, before and after switching groups, from between April 2014 and March 2016. Results We evaluated 443 treatment courses in 83 patients. The proportion of courses that included salvage antiemetic therapy in the control group and the study group was 34.8 {\%} (116/333) and 8.2 {\%} (9/110), respectively, and was statistically significant (p < 0.001). The mean integrated costs of antiemetics per course in the control group and the study group were 193 ± 55 USD and 143 ± 38 USD, respectively. Multivariate logistic regression analysis revealed that the study group was significantly associated with a reduced risk of requiring salvage antiemetic therapy (p = 0.038). Conclusions These results suggest that the antiemetic effectiveness and cost-saving of a three-drug combination of aprepitant, generic granisetron, and dexamethasone was superior to a two-drug combination of palonosetron plus dexamethasone in gastrointestinal cancer patients who received MEC.",
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T1 - Antiemetic effectiveness and cost-saving of aprepitant plus granisetron is superior to palonosetron in gastrointestinal cancer patients who received moderately emetogenic chemotherapy

AU - Toda, Haruka

AU - Kawazoe, Hitoshi

AU - Yano, Akiko

AU - Yamamoto, Yuji

AU - Watanabe, Yuji

AU - Yamamoto, Yasunori

AU - Hiasa, Yoichi

AU - Yakushijin, Yoshihiro

AU - Tanaka, Akihiro

AU - Araki, Hiroaki

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Purpose The therapeutic benefit of a three-drug combination of antiemetics has not been established in moderately emetogenic chemotherapy (MEC). The aim of this study was to compare the antiemetic effectiveness and cost-saving of palonosetron plus dexamethasone (control group) with aprepitant, granisetron, and dexamethasone (study group) in cancer patients who received MEC. Methods We switched the standard antiemetic treatment from the control group to the study group in gastrointestinal cancer patients who received MEC after October 2015. The antiemetics in both groups were modified using salvage antiemetic therapy at the clinicians' discretion, according to the severity of chemotherapy-induced nausea and vomiting. We retrospectively reviewed the electronic medical records from patients, before and after switching groups, from between April 2014 and March 2016. Results We evaluated 443 treatment courses in 83 patients. The proportion of courses that included salvage antiemetic therapy in the control group and the study group was 34.8 % (116/333) and 8.2 % (9/110), respectively, and was statistically significant (p < 0.001). The mean integrated costs of antiemetics per course in the control group and the study group were 193 ± 55 USD and 143 ± 38 USD, respectively. Multivariate logistic regression analysis revealed that the study group was significantly associated with a reduced risk of requiring salvage antiemetic therapy (p = 0.038). Conclusions These results suggest that the antiemetic effectiveness and cost-saving of a three-drug combination of aprepitant, generic granisetron, and dexamethasone was superior to a two-drug combination of palonosetron plus dexamethasone in gastrointestinal cancer patients who received MEC.

AB - Purpose The therapeutic benefit of a three-drug combination of antiemetics has not been established in moderately emetogenic chemotherapy (MEC). The aim of this study was to compare the antiemetic effectiveness and cost-saving of palonosetron plus dexamethasone (control group) with aprepitant, granisetron, and dexamethasone (study group) in cancer patients who received MEC. Methods We switched the standard antiemetic treatment from the control group to the study group in gastrointestinal cancer patients who received MEC after October 2015. The antiemetics in both groups were modified using salvage antiemetic therapy at the clinicians' discretion, according to the severity of chemotherapy-induced nausea and vomiting. We retrospectively reviewed the electronic medical records from patients, before and after switching groups, from between April 2014 and March 2016. Results We evaluated 443 treatment courses in 83 patients. The proportion of courses that included salvage antiemetic therapy in the control group and the study group was 34.8 % (116/333) and 8.2 % (9/110), respectively, and was statistically significant (p < 0.001). The mean integrated costs of antiemetics per course in the control group and the study group were 193 ± 55 USD and 143 ± 38 USD, respectively. Multivariate logistic regression analysis revealed that the study group was significantly associated with a reduced risk of requiring salvage antiemetic therapy (p = 0.038). Conclusions These results suggest that the antiemetic effectiveness and cost-saving of a three-drug combination of aprepitant, generic granisetron, and dexamethasone was superior to a two-drug combination of palonosetron plus dexamethasone in gastrointestinal cancer patients who received MEC.

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KW - Cost-saving

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