Can Aprepitant Improve Survival for Women With Breast Cancer?

Study finds anti-nausea drug aprepitant boosts distant disease-free and breast cancer-specific survival in early-stage triple-negative breast cancer: © stock.adobe.com.

A commonly prescribed anti-nausea medication, aprepitant, was found to be associated with better prognosis for women with early-stage breast cancer, particularly triple-negative breast cancer, according to a news release from Monash Australia.

Results are based off a study published in the Journal of the National Cancer Institute by lead study author Dr. Aeson Chang who is an assistant professor equivalent at Monash University.

“Because of the nature of triple-negative breast cancer, there are fewer targeted treatment options, and therefore repurposing of drugs with well-established safety profiles is an attractive path for rapid translation to improve cancer treatment and outcomes,” Chang cited in her research.

During chemotherapy, 7,047 women (51%) received aprepitant. Its use was associated with improved distant disease-free survival (DDFS, 11% improvement) and breast cancer-specific survival (BCSS, 17% improvement). The survival benefit was limited to women with non-luminal breast cancer (DDFS, 31% improvement; BCSS, 36% improvement) and was strongest in those with triple-negative breast cancer (DDFS, 34% improvement; BCSS, 39% improvement). Among women with non-luminal breast cancer, longer use of aprepitant was linked to increasingly favorable survival outcomes. In contrast, other antiemetics from different drug classes were not associated with survival.

Researchers used nationwide registry data in Norway to examine 13,811 women diagnosed with early breast cancer between 2008 and 2020 who were treated with chemotherapy and antiemetics. Follow-up for metastasis and breast cancer-related death began 1 year after diagnosis and continued through 2021. To explore the relationship between aprepitant use and outcomes such as distant disease-free survival and breast cancer-specific survival, the team conducted analyses that adjusted for tumor and patient factors, chemotherapy regimens and the use of other antiemetics.

Chang continued, “Very little is known about how and why aprepitant use could impact long term survival outcomes in women with breast cancer, which is why we wanted to examine whether its use at the time of chemotherapy treatment may be linked with survival outcomes in a large population-based cohort of women with early-stage breast cancer.”

Dr Chang further noted the results suggest it may be worth studying whether aprepitant could be used more widely to help prevent chemotherapy-related nausea.

What is Aprepitant and How Does it Work?

According to the National Cancer Institute’s website, cancer.gov, aprepitant is a medicine given with other drugs to help prevent nausea and vomiting from chemotherapy or after surgery. It works by blocking a chemical in the nervous system that can trigger nausea, which may make these symptoms less likely. Aprepitant is also called Cinvanti or Emend.

Professor Erica Sloan, co-senior author from MIPS, said the team was encouraged to see a strong connection between aprepitant use and improved survival in women with triple negative breast cancer.

“Triple negative breast cancer can be especially challenging to treat and with around 3,000 new cases diagnosed each year in Australia, new treatment pathways are important. We believe further studies are urgently needed to evaluate the effect of aprepitant in preventing cancer relapse and potentially inform new anti-nausea prescribing guidelines down the track,” Professor Sloan said.

Chemotherapy often causes nausea and vomiting, affecting up to 60% of patients with early-stage breast cancer. Current recommendations limit aprepitant to patients receiving chemotherapy that is most likely to cause these side effects.

In preclinical studies, researchers have found that aprepitant can slow the growth of breast tumors, according to the news release.

References

1. “Antinausea medication linked to higher survival rates in women with triple negative breast cancer,” by Monash Australia. News Release. July 15, 2025.
2. “Aprepitant use during chemotherapy and association with survival in women with early breast cancer,” by Dr. Edoardo Botteri, et al. Journal of the National Cancer Institute.

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