Source:Current Problems in Cancer
Author(s): Hussien Ahmed, Ali Mohamed Hammad, Abdelrahman Ibrahim Abushouk, Mohamed Zidan, Mohamed Salem, Ahmed Negida, Mohamed M. Abdel-Daim
Although chemotherapeutic agents represent a cornerstone of cancer treatment, chemotherapy-induced nausea and vomiting (CINV) is one of the most disturbing hazards of cytotoxic therapy that affects the patients' quality of life and basic daily activities. Rolapitant is a novel selective neurokinin-1 receptor antagonist (NK-1 RA), which was clinically approved for prevention of CINV. The aim of the present study is to synthesize evidence about the safety and efficacy of rolapitant in combination with other antiemetic agents for prophylaxis against CINV. We performed a web-based literature search of six authentic databases to identify eligible studies. Safety and efficacy endpoints were extracted and pooled as odds ratios (ORs) in a fixed-effect meta-analysis model, using Comprehensive Meta-Analysis software for windows. Five randomized controlled trials (n=2984) were pooled in the final analysis. Rolapitant (180mg) in combination with a serotonin-3 (5-HT3) receptor antagonist and dexamethasone was superior to placebo plus 5-HT3 receptor antagonist and dexamethasone in term of complete response rate in the acute (OR 1.4, 95% CI [1.16, 1.7]) and the delayed phases (OR 1.68, 95% CI [1.44, 1.96]. Moreover, rates of complete protection were significantly higher with rolapitant 180mg group than placebo in the overall, acute, and delayed phases (OR 1.52, 95% CI [1.3, 1.76]), OR 1.24, 95% CI [1.04, 1.49], OR 1.5, 95% CI [1.29, 1.75]), respectively. It could be concluded that, Rolapitant in combination with a 5-HT3 receptor antagonist and dexamethasone is well tolerated and more effective than 5-HT3 receptor antagonist plus dexamethasone and placebo for the prevention of CINV.
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