Kevin Thai, Jennifer Jupp, Deonne Dersch-Mills, Sunita Ghosh, Mona Shafey, Leanne Fong
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Reduced activation of cyclophosphamide may reduce the effectiveness of dose-intensive cyclophosphamide, etoposide, and cisplatin (DICEP).</p><p><strong>Objectives: </strong>To compare response rates to DICEP in patients with Hodgkin lymphoma (HL) and diffuse large B-cell lymphoma (DLBCL) in the presence and absence of aprepitant.</p><p><strong>Methods: </strong>A retrospective review of patients who received full-dose DICEP for relapsed/refractory HL or DLBCL between June 1995 and September 2018 at the Foothills Medical Centre (FMC) in Calgary, Alberta, Canada was conducted. Descriptive statistics were used to assess response rate, as defined by the 2007 International Working Group response criteria.</p><p><strong>Results: </strong>Of the 218 patients included in this study, 87.6% of patients in the control group and 88.5% of patients in the aprepitant group responded to DICEP (difference 0.025 [95% CI, -0.066 to 0.114], p = 0.827). Univariate analyses for age, sex, type of cancer, stage of cancer, number of prior relapses, and relapse status were not significant. No significant differences were observed for secondary outcomes.</p><p><strong>Conclusion: </strong>Response rates to DICEP in relapsed/refractory HL and DLBCL patients were similar regardless of aprepitant use. Considering these results and the effectiveness of aprepitant in CINV, its addition to standard antiemetic therapy in patients receiving DICEP should be given strong consideration in the transplant setting.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessing the impact of aprepitant on response to dose-intensive cyclophosphamide, etoposide, and cisplatin (DICEP).\",\"authors\":\"Kevin Thai, Jennifer Jupp, Deonne Dersch-Mills, Sunita Ghosh, Mona Shafey, Leanne Fong\",\"doi\":\"10.1177/10781552241269722\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Despite evidence demonstrating the effectiveness of aprepitant for chemotherapy-induced nausea and vomiting (CINV), its use in stem cell transplant settings across Canada is not standard. 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引用次数: 0
摘要
背景:尽管有证据表明阿瑞匹坦对化疗引起的恶心和呕吐(CINV)有效,但在加拿大各地的干细胞移植环境中,阿瑞匹坦的使用并不规范。虽然存在药代动力学数据,但阿普瑞坦抑制环磷酰胺的细胞色素P450 3A4(CYP 3A4)的临床意义尚不清楚。环磷酰胺的活化降低可能会降低剂量强化环磷酰胺、依托泊苷和顺铂(DICEP)的疗效:比较霍奇金淋巴瘤(HL)和弥漫大B细胞淋巴瘤(DLBCL)患者在阿普瑞坦存在和不存在的情况下对DICEP的反应率:对1995年6月至2018年9月期间在加拿大阿尔伯塔省卡尔加里市麓山医疗中心(FMC)接受全剂量DICEP治疗复发/难治性HL或DLBCL的患者进行了回顾性研究。根据2007年国际工作组反应标准的定义,采用描述性统计来评估反应率:在纳入该研究的 218 名患者中,87.6% 的对照组患者和 88.5% 的阿瑞匹坦组患者对 DICEP 有反应(差异为 0.025 [95% CI, -0.066 to 0.114], p = 0.827)。年龄、性别、癌症类型、癌症分期、既往复发次数和复发状况的单变量分析结果均无显著性差异。次要结果无明显差异:无论是否使用阿瑞匹坦,复发/难治性HL和DLBCL患者对DICEP的应答率相似。考虑到这些结果以及阿普瑞坦对CINV的疗效,在移植环境中,接受DICEP的患者在标准止吐疗法的基础上加用阿普瑞坦应得到慎重考虑。
Assessing the impact of aprepitant on response to dose-intensive cyclophosphamide, etoposide, and cisplatin (DICEP).
Background: Despite evidence demonstrating the effectiveness of aprepitant for chemotherapy-induced nausea and vomiting (CINV), its use in stem cell transplant settings across Canada is not standard. While pharmacokinetic data exists, the clinical significance of cytochrome P450 3A4 (CYP 3A4) inhibition of cyclophosphamide by aprepitant is unclear. Reduced activation of cyclophosphamide may reduce the effectiveness of dose-intensive cyclophosphamide, etoposide, and cisplatin (DICEP).
Objectives: To compare response rates to DICEP in patients with Hodgkin lymphoma (HL) and diffuse large B-cell lymphoma (DLBCL) in the presence and absence of aprepitant.
Methods: A retrospective review of patients who received full-dose DICEP for relapsed/refractory HL or DLBCL between June 1995 and September 2018 at the Foothills Medical Centre (FMC) in Calgary, Alberta, Canada was conducted. Descriptive statistics were used to assess response rate, as defined by the 2007 International Working Group response criteria.
Results: Of the 218 patients included in this study, 87.6% of patients in the control group and 88.5% of patients in the aprepitant group responded to DICEP (difference 0.025 [95% CI, -0.066 to 0.114], p = 0.827). Univariate analyses for age, sex, type of cancer, stage of cancer, number of prior relapses, and relapse status were not significant. No significant differences were observed for secondary outcomes.
Conclusion: Response rates to DICEP in relapsed/refractory HL and DLBCL patients were similar regardless of aprepitant use. Considering these results and the effectiveness of aprepitant in CINV, its addition to standard antiemetic therapy in patients receiving DICEP should be given strong consideration in the transplant setting.
期刊介绍:
Journal of Oncology Pharmacy Practice is a peer-reviewed scholarly journal dedicated to educating health professionals about providing pharmaceutical care to patients with cancer. It is the official publication of the International Society for Oncology Pharmacy Practitioners (ISOPP). Publishing pertinent case reports and consensus guidelines...