Safety and tolerability of intravenous aprepitant and fosaprepitant in children with cancer: A retrospective, single-center review

Pediatr Blood Cancer. 2024 Apr;71(4):e30882. doi: 10.1002/pbc.30882. Epub 2024 Jan 24.

Abstract

NK-1 receptor antagonists (NK1-RA) are key agents for chemotherapy-induced nausea and vomiting (CINV) prevention in patients receiving highly emetogenic chemotherapy. Current pediatric practice guidelines recommend the use of intravenous fosaprepitant or oral aprepitant. However, there are reports of hypersensitivity reactions with fosaprepitant due to polysorbate 80. Intravenous aprepitant does not contain polysorbate 80, but its use in pediatric patients has not been described. In this retrospective, single-center study, 106 pediatric patients received either fosaprepitant or intravenous aprepitant as part of their antiemetic regimen. Intravenous aprepitant was well tolerated and did not lead to any instances of hypersensitivity reactions requiring discontinuation.

Keywords: CINV; antiemetics; aprepitant; fosaprepitant; supportive care.

MeSH terms

  • Antiemetics* / adverse effects
  • Antineoplastic Agents* / adverse effects
  • Aprepitant / therapeutic use
  • Child
  • Humans
  • Hypersensitivity*
  • Morpholines*
  • Neoplasms* / complications
  • Neoplasms* / drug therapy
  • Polysorbates / adverse effects
  • Retrospective Studies
  • Vomiting / chemically induced
  • Vomiting / drug therapy
  • Vomiting / prevention & control

Substances

  • Aprepitant
  • fosaprepitant
  • Polysorbates
  • Antineoplastic Agents
  • Antiemetics
  • Morpholines