Anthracycline-containing regimens for breast cancer are classified as highly emetogenic chemotherapy. Aprepitant (A), palonosetron (P), granisetron (G) and dexamethasone (D) are recommended as antiemetic drugs. However, patients with hepatitis B or diabetes mellitus had better avoid dexamethasone. We retrospectively examined the efficacy of these antiemetic drugs without dexamethasone.Patients and methods
We reviewed the medical records of 97 breast cancer patients with hepatitis B or diabetes mellitus, who were treated with anthracycline-containing regimens between August 2009 and September 2010. Three antiemetic regimens were used. G: G 3 mg on day 1 (i.v.), and 2 mg on days 2–6 (p.o.); AG: A 125 mg on day 1 (i.v.), then 80 mg on days 2–3 (p.o.), and G 3 mg on day 1 (i.v.), then 2 mg on days 2–6 (p.o.); AP: A 125 mg on day 1 (i.v.), then 80 mg on days 2–3 (p.o.), and P 0.75 mg on day 1 ( i.v.).Result
The number of patients who were treated with G, AG, and AP were 29, 29, and 39, respectively. Complete response (CR) rate in acute phase (0–24h) or delayed phase (24–120 h) were G; 44.8%, 44.8%, AG; 72.4%, 72.4%, and AP; 76.9%, 74.4%. Complete control (CC) rate in acute or delayed phase in each regimens were G; 31.0%, 27.6%, AG; 48.2%, 51.7%, and AP; 46.2 %, 46.2%. AG or AP was superior to G in CR rate and CC rate of acute or delayed phase.Conclusion
The combination with AG or AP was effective antiemetic therapy for anthracycline containing regimens in breast cancer patients who should avoid dexamethasone.