Casopitant reduced chemotherapy-induced vomiting

Casopitant, a neurokinin 1 receptor agonist, was more effective than a control regimen at reducing chemotherapy-induced vomiting and was well tolerated for patients assigned to moderately emetogenic chemotherapy, according to findings from a phase-3 trial.

Researchers randomly assigned patients to placebo (n=483); a single oral dose of 150 mg casopitant on day one (n=483); a three-day oral dose of 150 mg casopitant on day one plus 50 mg on days two to three (n=483); or a three-day IV dose of 90 mg on day one plus 50 mg orally on days two to three (n=484). All patients were assigned to 8 mg IV dexamethasone on day one and 8 mg oral ondansetron twice daily on days one to three.

Compared with 59% in the control group, the overall complete response rate — defined as no vomiting/retching or rescue medications — was 73% in the single-dose group, 73% in the three-day oral-dose group and to 74% in the IV/oral-dose group (P<.001 for all).

There was no difference between the casopitant groups and the placebo group for complete response during the acute phase.

The number of patients with no nausea and no significant nausea was similar among all four groups. The number of patients who had overall complete control and overall complete protection was similar as well. More patients in the casopitant groups reported no vomiting than in the placebo group (P<.0001). Casopitant was generally well tolerated, according to the researchers.

Herrstedt J. J Clin Oncol. 2009;doi:10.1200/JCO.2009.21.8511.