Background: Rolapitant, a novel NK-1 receptor antagonist, showed efficacy for prevention of CINV in patients (pts) receiving MEC (anthracycline/cyclophosphamide (A/C) and other regimens) in a global phase 3 trial. Recent anti-emetic guidelines consider A/C based regimens to be highly emetogenic. In this post hoc analysis, the efficacy and safety of rolapitant was assessed during Cycle 1 in pts receiving non-AC MEC. Methods: In a double-blind, active-controlled study, pts were randomized to oral rolapitant 200 mg or placebo 1–2 hours before MEC. All pts received granisetron 2 mg oral on days 1-3 and oral dexamethasone 20 mg on day 1. Pt subgroups were carboplatin-based MEC and Other MEC (OM; non-AC, non-carboplatin). Complete response (CR=no emesis and no use of rescue medication), no emesis, and no nausea were assessed during overall (0-120 h), acute (0-24 h), and delayed (>24-120 h) phases. Results: CR was significantly (P<0.05) higher with rolapitant than active control for overall and delayed phases in the carboplatin subset and for acute and overall phases in the OM subset (Table). No emesis rates were significantly (p<0.05) higher with rolapitant in carboplatin and OM subsets in the overall phase. No nausea rates were significantly higher with rolapitant during the overall (p= 0.023) and delayed (p=0.034) phases in carboplatin-based MEC. Incidences of treatment-related AEs in Cycle 1 with rolapitant vs. active control were 11.3% vs. 6.7% in carboplatin-based and 9.2% vs. 6.0% in OM-based therapy. Most common AEs with rolapitant and active control were constipation, fatigue, and headache. Conclusions: Rolapitant was superior to active control in preventing CINV in pt subgroups receiving either carboplatin or other non-AC MEC regimens. Rolapitant was well tolerated with low incidence of AEs. Clinical trial information: NCT01500226

^aunstratified CMH test.