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SYSTEMATIC REVIEW article

Front. Pharmacol.
Sec. Obstetric and Pediatric Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1509928

Fosaprepitant as combination therapy to prevent chemotherapy-induced vomiting in children：A Meta-analysis

Provisionally accepted
Yanshuo SHI Yanshuo SHI Yuanyuan YUE Yuanyuan YUE *Yue ZHANG Yue ZHANG *Guoxun PANG Guoxun PANG *
  • Hebei General Hospital, Shijiazhuang, China

The final, formatted version of the article will be published soon.

    To systematically evaluate the clinical efficacy and safety of fosaprepitant combined with 5-hydroxytryptamine 3 receptor antagonists (5-HT3RA) (with or without dexamethasone) on the chemotherapy-induced vomiting in pediatric cancer patients. Methods: PubMed, Embase, Cochrane Library, China Journal full-text database (CNKI), Wanfang data knowledge service platform (Wanfang) and VIP Chinese sci-tech Journal full-text database (VIP) were searched by computer (retrieval time from database establishment to Apr. 2024), randomized controlled trials (RCTs) and cohort studies about fosaprepitant and 5-HT3RA with or without dexamethasone (observation group) versus 5-HT3RA, with or without dexamethasone, as the control group for chemotherapy-induced vomiting were collected, after data extraction and quality evaluation, meta-analysis was carried out by Rev Man 5.3 software. Results: A total of 731 patients were included in 7 trials. Meta-analysis results showed that the complete response (CCR, no vomiting/rescue medication) rates were higher in the observation group compared to that in the control group during the acute [the relative risk: RR = 1.64, 95% confidence interval: 95%CI = 1.35~1.99, P < 0.00001], delayed vomiting [RR = 2.05, 95%CI = 1.32~3.17, P = 0.001] and overall phases [RR = 2.08, 95%CI = 1.69~2.57, P < 0.00001], with statistical significance (P < 0.05). The subgroup analysis of salvage treatment proportion revealed that the need for rescue medication was higher for patients in the control than fosaprepitan regimens [RR = 0.20, 95%CI = 0.08~0.54, P = 0.001] There was no difference in the incidence of adverse drug reaction between two groups [RR = 0.95, 95%CI = 0.75~1.19, P = 0.66]. Conclusion Fosaprepitant in combination with 5-HT3RA (with or without dexamethasone) has the same safety and more effective in preventing chemotherapy-induced vomiting than 5-HT3RA with or without dexamethasone.

    Keywords: ：Fosaprepitant, chemotherapy, pediatric cancer, antiemetic prophylaxis, Meta-analysis

    Received: 11 Oct 2024; Accepted: 06 Jan 2025.

    Copyright: © 2025 SHI, YUE, ZHANG and PANG. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yuanyuan YUE, Hebei General Hospital, Shijiazhuang, China
    Yue ZHANG, Hebei General Hospital, Shijiazhuang, China
    Guoxun PANG, Hebei General Hospital, Shijiazhuang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.