Fosaprepitant Versus Aprepitant in the Prevention of Chemotherapy Induced Nausea and Vomiting

Inclusion Criteria: * Female Gender * Age \> 18 years * A histologic diagnosis of stage III/IV gynecologic cancer (e.g., epithelial ovarian, fallopian tube, peritoneal cancer and uterine cancer). * Subjects who will be treated with Taxol and Carboplatin as standard of care for a newly diagnosed gynecological cancer. * Adequate bone marrow function as demonstrated by: Absolute neutrophil count (ANC) \> 1,500/μL; platelet count \> 100,000/μL; and hemoglobin \> 9 g/dL • Adequate renal function demonstrated by: Serum creatinine of \< 1.5 x ULN or 24-hr measured urine creatinine clearance \> 60 mL/min for patients with serum creatinine \> 1.5 x ULN • Adequate hepatic function demonstrated by: Total bilirubin of \< 1.5 x ULN AST or ALT ≤ 2.5 x ULN * EGOG status of \< 2: Postoperatively, patients demonstrate an ECOG score of 1 or 2. However, during the first cycle of chemotherapy, the patients' performance status improves to \< 1. * Projected life expectancy of at least 3 months * Ability to comply with the visit schedule and assessments required by the protocol * Negative pregnancy test for women of childbearing potential * Signed, IRB approved informed consent and HIPPA consent Exclusion Criteria: * Subjects with a diagnosis of epithelial ovarian, fallopian tube or peritoneal cancers of low malignant potential (borderline carcinomas) are not eligible. * Allergy or intolerance to 5HT3 or NK-1 antagonists and dexamethasone * An episode of vomiting or retching within 24 hours before the start of the initial treatment with chemotherapy * Subjects with concomitant malignancy or a previous malignancy within the past three (3) years (except non-melanoma skin cancer) * Current, recent (within 4 weeks of the first infusion of this study), or planned participation in an experimental drug study. * Screening clinical laboratory values of: ANC of \<1500/DL Platelet count of \<100,000/µL Total bilirubin of \*1.5 mg/dL x ULN SGOT (AST) or SGPT (ALT) \* 2.5 x ULN Serum creatinine of \* 1.5 mg/dL Hemoglobin of \* 9 gm/dL (may be transfused or receive a colony stimulating factor to maintain or exceed this level) * EGOG status of \> 2 * Gastrointestinal obstruction or an active peptic ulcer * Patients who are pregnant or breast feeding because aprepitant may be harmful to the developing fetus and newborn * Known active HIV and viral hepatitis infections * Inability to comply with study * New York Heart Association (NYHA) Grade II or greater congestive heart failure (see Appendix D)