The investigational agent aprepitant shows promise as a preventive of nausea and vomiting associated with highly emetogenic chemotherapy (regimens that produce vomiting in 90 percent of patients who do not receive antiemetic therapy).

An advisory committee of the Food and Drug Administration agreed that aprepitant, in combination with standard antiemetic therapy of a 5-HT3 receptor antagonist plus corticosteroid, demonstrated efficacy in prevention of both acute and delayed phase vomiting. The Administration has not yet made a decision on approval for use in the U.S.

The data reviewed by the committee came from studies that evaluated a combined antiemetic regimen including aprepitant taken for 3 days in patients receiving highly emetogenic chemotherapy as an effective and safe preventive of nausea and vomiting within the first 24 hours of drug administration and up to 5 days following chemotherapy. The studies included patients who received the experimental regimen over multiple cycles of chemotherapy.

Currently, there is no antiemetic therapy approved in the U.S. for delayed phase symptoms following chemotherapy.

Aprepitant is a Substance P neurokinin-1 receptor antagonist. Researchers believe that antagonism of these receptors prevents nausea and vomiting by blocking brain responses to the chemotherapeutic agents.