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Aprepitant, fosaprepitant and risk of ifosfamide-induced neurotoxicity: a systematic review

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Abstract

Ifosfamide is one of the chemotherapy regimens which potentially causes neurotoxicity in patients up to 30%. Aprepitant is administered as an anti-emetic agent in chemotherapy and regarding the inhibitory effect on CYP3A4, aprepitant can increase the risk of ifosfamide adverse effects. This study aims to systematically investigate the relation of ifosfamide-induced neurotoxicity and aprepitant or fosaprepitant in chemotherapy cancer patients. Four databases including PubMed, Scopus, Web of Science, and Embase were systematically reviewed without language restriction and hand searching was performed until December 2021. Total 1639 publications were retrieved and nine studies fulfilled the eligibility criteria. For quality assessment, we used Newcastle–Ottawa quality assessment scales (NOS) for retrospective cohort studies and Cochrane Collaboration tool to assess the risk of bias for a randomized controlled trial. Overall, the results of our systematic review indicated a positive enhanced trend between neurotoxicity and concomitant use of ifosfamide and aprepitant or fosaprepitant, but the association was not statistically significant. As indicated by our findings, several studies identified low albumin as a risk factor for ifosfamide-induced encephalopathy. However, further clinical studies with a larger population of patients are required to evaluate the clinical significance of ifosfamide-related neurotoxicity and aprepitant or fosaprepitant.

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Author notes

  1. Fatemeh Vazirian and Sara Samadi equally contributed as the first author.

Authors and Affiliations

  1. Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

    Fatemeh Vazirian, Sara Samadi & Amir Hooshang Mohammadpour

  2. Department of Internal Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

    Hossein Rahimi

  3. Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran

    Masoomeh Sadeghi

  4. Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran

    Amir Hooshang Mohammadpour

Authors
  1. Fatemeh Vazirian
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  2. Sara Samadi
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  3. Hossein Rahimi
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  4. Masoomeh Sadeghi
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  5. Amir Hooshang Mohammadpour
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Contributions

All authors contributed to the study conception and design. Fatemeh Vazirian and Sara Samadi independently screened and extracted the data of the articles and wrote the original draft. Amir Hooshang Mohammadpour and Masoomeh Sadeghi and Hossein Rahimi resolved any discrepancies during screening and data extraction and also revised the manuscript. All authors reviewed, considered and approved the manuscript.

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Correspondence to Amir Hooshang Mohammadpour.

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Vazirian, F., Samadi, S., Rahimi, H. et al. Aprepitant, fosaprepitant and risk of ifosfamide-induced neurotoxicity: a systematic review. Cancer Chemother Pharmacol 90, 1–6 (2022). https://doi.org/10.1007/s00280-022-04439-x

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  • DOI: https://doi.org/10.1007/s00280-022-04439-x

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