Antipruritic vs. Antitumour Action of Aprepitant: A Question of Dose.

Abstract

A recently published study of 8 patients with cutaneous T-cell lymphomas (CTCL) treated with aprepitant (1) reported that the neurokinin-1 receptor (NK-1R) antago-nist aprepitant did not completely modify CTCL disease activity. The authors concluded that these findings do not support future research focused on the anti-lymphoma action of NK-1R antagonists (1). The same group publi-shed another study of 17 patients, which reported that, in primary CTCL, there was an improvement in refractory pruritus, and that aprepitant was safe, well-tolerated and effective for treatment of severe chronic itch in patients with CTCL who failed to respond to classical antipruritic treatments (2). The latter study is in agreement with the data suggesting that, in the skin, NK-1R antagonists play an important role in anti-itch activity (2). These authors reported that the best antipruritic response was found in lymphomas limited to skin (stages IB–IIB) and non-erythroderma cutaneous lesions (stage T4) (2). In both studies (1, 2), aprepitant (standard 125–80–80 mg) was administered every 2 weeks for a mean of 20 weeks, or weekly for 8 weeks. In standard clinical practice, apre-pitant (first day 125 mg; second day 80 mg; third day 80 mg) is used to treat chemotherapy-induced nausea and vomiting.