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Aprepitant in the Prevention of Vomiting Induced by Moderately and Highly Emetogenic Chemotherapy

  • Wang, Shi-Yong (Department of Biotherapy and Laboratory of Biotherapy, the Fourth Affiliated Hospital of China Medical University) ;
  • Yang, Zhen-Jun (Department of Medical Information, Shengjing Hospital of China Medical University) ;
  • Zhang, Zhe (Department of Biotherapy and Laboratory of Biotherapy, the Fourth Affiliated Hospital of China Medical University) ;
  • Zhang, Hui (Department of Biotherapy and Laboratory of Biotherapy, the Fourth Affiliated Hospital of China Medical University)
  • Published : 2015.01.06

Abstract

Chemotherapy is a major therapeutic approach for malignant neoplasms; however, due to the most common adverse events of nausea and vomiting, scheduled chemotherapeutic programs may be impeded or even interrupted, which severely impairs the efficacy. Aprepitants, 5-HT3 antagonists and dexamethasone are primary drugs used to prevent chemotherapy-induced nausea and vomiting (CINV). These drugs have excellent efficacy for control of acute vomiting but are relatively ineffective for delayed vomiting. Aprepitant may remedy this deficiency. Substance P was discovered in the 1930s and its association with vomiting was confirmed in the 1950s. This was followed by a period of non-peptide neurokinin-1 (NK-1) receptor antagonist synthesis and investigation in preclinical studies and clinical trials (phases I, II and III). The FDA granted permission for the clinical chemotherapeutic use of aprepitant in 2003. At present, the combined use of aprepitant, 5-HT3 antagonists and dexamethasone satisfactorily controls vomiting but not nausea. Therefore, new therapeutic approaches and drugs are still needed.

Keywords

Neurokinin-1 receptor antagonist;aprepitant;substance P;chemotherapy-induced nausea and vomiting

Acknowledgement

Supported by : Natural Science Foundation of Liaoning Province

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