Фосапрепитант: современные возможности предупреждения тошноты и рвоты, индуцированных химиотерапией

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Аннотация

Актуальность. Среди современных методов лечения злокачественных опухолей химиотерапия (ХТ) занимает лидирующее положение. Тошнота и рвота, индуцированные ХТ, наблюдаются у 30–90% пациентов на протяжении 0–120 ч после применения умеренно и высокоэметогенной ХТ. Их наличие может весьма серьезно повлиять на качество лечения, повседневную жизнедеятельность и приверженность лечению, что снижает эффективность терапии и продолжительность жизни.

Материалы и методы. Автор приводит результаты систематического обзора научных статей, включая клинические исследования, посвященные эффективности применения антагониста рецепторов нейрокинина-1 фосапрепитанта для предотвращения тошноты и рвоты, индуцированных ХТ. Исследовались данные из базы PubMed.

Результаты. Предупреждение и лечение тошноты и рвоты, ассоциированных с ХТ, представляет жизненно важную проблему, и ее следует рассматривать как необходимый этап при применении специальных методов лечения, включая симптоматическую терапию. С этой целью международные организации рекомендуют применять тройную комбинацию с включением антагонистов рецепторов нейрокинина-1, серотониновых 5-гидрокситриптамин-3-рецепторов и дексаметазона. Согласно полученным данным эффективность фосапрепитанта доказана в острой, отсроченной и общей фазах в ряде крупных, хорошо спланированных исследований – препарат позволяет снизить частоту нежелательных явлений в 2,7–4,4 раза по сравнению с апрепитантом.

Заключение. Фосапрепитант является антагонистом рецепторов нейрокинина-1, при внутривенном введении он быстро превращается в апрепитант. Применение его в составе триплета с антагонистами серотониновых 5-гидрокситриптамин-3-рецепторов и дексаметазоном у пациентов, получающих умеренно и высокоэметогенную ХТ, позволяет достичь большей частоты полных ответов при контроле тошноты и рвоты. В целом фосапрепитант хорошо переносится.

Об авторах

Николай Алексеевич Огнерубов

ФГБОУ ВО «Тамбовский государственный университет им. Г.Р. Державина»

Автор, ответственный за переписку.
Email: ognerubov_n.a@mail.ru
ORCID iD: 0000-0003-4045-1247

д-р мед. наук, канд. юрид. наук, проф., зав. каф. онкологии Медицинского института, засл. работник высшей школы РФ, засл. врач РФ

Россия, Тамбов

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