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. 2018 Jan 16:8:972.
doi: 10.3389/fphar.2017.00972. eCollection 2017.

Rikkunshito for Preventing Chemotherapy-Induced Nausea and Vomiting in Lung Cancer Patients: Results from 2 Prospective, Randomized Phase 2 Trials

Toshiyuki Harada  1 , Toraji Amano  2 , Tomoo Ikari  1 , Kei Takamura  3 , Takahiro Ogi  3 , Toshiaki Fujikane  4 , Yuka Fujita  4 , Kageaki Taima  5 , Hisashi Tanaka  5 , Takaaki Sasaki  6 , Shunsuke Okumura  6 , Shunichi Sugawara  7 , Hiroshi Yokouchi  8 , Noriyuki Yamada  9 , Naoto Morikawa  10 , Hirotoshi Dosaka-Akita  11 , Hiroshi Isobe  12 , Masaharu Nishimura  13
Affiliations

Rikkunshito for Preventing Chemotherapy-Induced Nausea and Vomiting in Lung Cancer Patients: Results from 2 Prospective, Randomized Phase 2 Trials

Toshiyuki Harada et al. Front Pharmacol. .

Abstract

The herbal medicine rikkunshito has the potential to improve chemotherapy-induced nausea and vomiting (CINV) by stimulating ghrelin secretion. We aimed to evaluate the efficacy and safety of rikkunshito in preventing CINV for patients with lung cancer. Two separate prospective, randomized, phase II parallel design studies were conducted in patients with lung cancer. Fifty-eight and sixty-two patients scheduled to receive highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC), respectively, were randomized 1:1 to receive either standard antiemetic therapy in accordance with international guidelines (S group) or standard antiemetic therapy plus oral rikkunshito (R group). The primary endpoint was overall complete response (CR)-that is, no emesis and rescue medication in the first 120 h post-chemotherapy. Secondary endpoints included CR in the acute (0-24 h) and delayed (>24-120 h) phases and safety. Fifty-seven patients (S group, 28; R group, 29) receiving HEC and sixty-two patients (S group, 30; R group, 32) receiving MEC with comparable characteristics were evaluated. The CR rates were similar across the S and R groups for the HEC study in the overall (67.9% vs. 62.1%), acute (96.4% vs. 89.6%), and delayed (67.9% vs. 62.1%) phases, respectively, and for the MEC study in the overall (83.3% vs. 84.4%), acute (100% vs. 100%), and delayed (83.3% vs. 84.4%) phases, respectively. No severe adverse events were observed. Although rikkunshito was well tolerated, it did not demonstrate an additional preventative effect against CINV in lung cancer patients receiving HEC or MEC. Clinical Trial Registry Information: This study is registered with the University Hospital Medical Information Network (UMIN) Clinical Trial Registry, identification numbers UMIN 000014239 and UMIN 000014240.

Keywords: chemotherapy; herbal medicine; lung cancer; nausea; vomiting.

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Figures

FIGURE 1
FIGURE 1
CONSORT diagram showing patients disposition in the highly emetogenic chemotherapy (HEC) study.
FIGURE 2
FIGURE 2
CONSORT diagram showing patients disposition in the moderately emetogenic chemotherapy (MEC) study.
See this image and copyright information in PMC

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