Study Assessing Fosaprepitant in Advanced NSCLC Patients Treated With Carboplatin Based Chemotherapy

Inclusion Criteria:

* Patient age \> 18 years and able to sign informed consent.
* ECOG PS 0-2
* Patients with stage IV or recurrent NSCLC being treated with carboplatin based regimen with palliative intent.
* Acceptable chemotherapy regimens include:
* Carboplatin (AUC of 5 OR 6) q 21 days with:

  * Paclitaxel Q 21 days OR
  * Docetaxel Q 21 days OR
  * Pemetrexed Q 21 days (non-squamous histology with Vitamin B12 and folate supplementation) OR
  * Gemcitabine administered days 1 and 8 Q 21 days OR
  * Vinorelbine administered days 1 and 8 Q 21 days
* The addition of bevacizumab to chemotherapy is permitted where indicated and clinically appropriate.
* Patients who have received prior adjuvant chemotherapy for lung cancer ( \> 1 year prior) and have recurred are eligible if it has been \> 1 year since completion of adjuvant chemotherapy.
* Patients who have been treated for locally advanced lung cancer with concurrent chemoradiation but completed such therapy \> 1 year ago are eligible provided they meet all other inclusion criteria.
* Patients who have received prior adjuvant chemotherapy for lung cancer ( \> 1 year prior) and have recurred are eligible if it has been \> 1 year since completion of adjuvant chemotherapy.
* Patients who have been treated for locally advanced lung cancer with concurrent chemoradiation but completed such therapy \> 1 year ago are eligible provided they meet all other inclusion criteria.
* Laboratory parameters:
* Serum creatinine \< 2.0 and
* AST, ALT \< 3 time the upper limit of normal
* Platelet count ≥ 100,00/cumm
* ANC ≥ 1500/ cumm on day of therapy (day # 1 of the cycle)
* Hemoglobin \> 8.0 g/dl

Exclusion Criteria:

* History of allergic reaction to aprepitant or fosaprepitant
* Use of other investigational agents concurrently with chemotherapy
* Uncontrolled systemic hypertension with SBP \> 180 and/ or DBP\> 110
* Concurrent use of pimozide, terfenadine, astemizole, or cisapride (fosaprepitatnt is a dose-dependent inhibitor of cytochrome P450 isoenzyme 3A4 (CYP3A4). If used concurrently with above agents, there can be elevated plasma concentrations of these drugs, potentially causing serious or life-threatening reactions. Patients may be enrolled on the study if at least 7 days have elapsed since last dose of such a medication.
* Women who are pregnant or lactating are not eligible. Women of childbearing age musthave a negative pregnancy test within 3 days of treatment and agree to use of contraception during the study period.
* Use of any of the CYP450 inducers like phenytoin, carbamazepine, barbiturates, rifimapicin, rifabutin or St John's wort within 30 days.