Skip to main content

Advertisement

SpringerLink
Log in

Impact of CINV in earlier cycles on CINV and chemotherapy regimen modification in subsequent cycles in Asia Pacific clinical practice

  • Special Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

We sought to describe the impact of chemotherapy-induced nausea and vomiting (CINV) in prior cycles on CINV and chemotherapy regimen modification in subsequent cycles.

Methods

Eligible patients in this multinational prospective observational study were adults (≥18 years old) receiving their first single-day highly or moderately emetogenic chemotherapy (HEC or MEC). Multivariate logistic regression was used to assess the impact of CINV in prior cycles on CINV in subsequent cycles. Other independent variables included in the model were the cycle number, age, sex, and emetogenicity of regimen.

Results

There were 598 evaluable patients in cycle 2 and 533 in cycle 3, half receiving HEC and half MEC. Patients who experienced complete response (no emesis or rescue antiemetics) in earlier cycles, relative to those with no complete response, had an adjusted odds ratio (OR) of 5.9 (95 % confidence interval (CI), 4.14–8.50) for experiencing complete response in subsequent cycles. Prior CINV was a significant and consistent predictor of subsequent CINV for all CINV endpoints: for emesis, OR 12.7 (95 % CI, 8.47–18.9), for clinically significant nausea, OR 7.9 (95 % CI, 5.66–10.9), and for clinically significant nausea and/or vomiting, OR 7.2 (5.17–10.1). Modifications to chemotherapy were recorded for 26–29 % of patients in cycles 2 and 3, with CINV as the major reason for the modification for 5–9 % of these patients.

Conclusions

CINV in prior cycles was a strong and consistent predictor of CINV in subsequent cycles, while the incidence of chemotherapy regimen modification due to CINV was low in individual cycles.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sun CC, Bodurka DC, Weaver CB, Rasu R, Wolf JK, Bevers MW, Smith JA, Wharton JT, Rubenstein EB (2005) Rankings and symptom assessments of side effects from chemotherapy: insights from experienced patients with ovarian cancer. Support Care Cancer 13(4):219–227. doi:10.1007/s00520-004-0710-6

    Article  PubMed  Google Scholar 

  2. de Boer-Dennert M, de Wit R, Schmitz PI, Djontono J, v Beurden V, Stoter G, Verweij J (1997) Patient perceptions of the side-effects of chemotherapy: the influence of 5HT3 antagonists. Br J Cancer 76(8):1055–1061

    Article  PubMed Central  PubMed  Google Scholar 

  3. Kuchuk I, Bouganim N, Beusterien K, Grinspan J, Vandermeer L, Gertler S, Dent SF, Song X, Segal R, Mazzarello S, Crawley F, Dranitsaris G, Clemons M (2013) Preference weights for chemotherapy side effects from the perspective of women with breast cancer. Breast Cancer Res Treat 142(1):101–107. doi:10.1007/s10549-013-2727-3

    Article  CAS  PubMed  Google Scholar 

  4. Ballatori E, Roila F, Ruggeri B, Betti M, Sarti S, Soru G, Cruciani G, Di Maio M, Andrea B, Deuson RR (2007) The impact of chemotherapy-induced nausea and vomiting on health-related quality of life. Support Care Cancer 15(2):179–185. doi:10.1007/s00520-006-0109-7

    Article  PubMed  Google Scholar 

  5. Cohen L, de Moor CA, Eisenberg P, Ming EE, Hu H (2007) Chemotherapy-induced nausea and vomiting: incidence and impact on patient quality of life at community oncology settings. Support Care Cancer 15(5):497–503

    Article  PubMed  Google Scholar 

  6. Fernandez-Ortega P, Caloto MT, Chirveches E, Marquilles R, Francisco JS, Quesada A, Suarez C, Zorrilla I, Gomez J, Zabaleta P, Nocea G, Llombart-Cussac A (2012) Chemotherapy-induced nausea and vomiting in clinical practice: impact on patients’ quality of life. Support Care Cancer 20(12):3141–3148. doi:10.1007/s00520-012-1448-1

    Article  CAS  PubMed  Google Scholar 

  7. Perwitasari DA, Atthobari J, Mustofa M, Dwiprahasto I, Hakimi M, Gelderblom H, Putter H, Nortier JW, Guchelaar HJ, Kaptein AA (2012) Impact of chemotherapy-induced nausea and vomiting on quality of life in indonesian patients with gynecologic cancer. Int J Gynecol Cancer 22(1):139–145. doi:10.1097/IGC.0b013e318234f9ee

    Article  PubMed  Google Scholar 

  8. Burke TA, Wisniewski T, Ernst FR (2011) Resource utilization and costs associated with chemotherapy-induced nausea and vomiting (CINV) following highly or moderately emetogenic chemotherapy administered in the US outpatient hospital setting. Support Care Cancer 19(1):131–140. doi:10.1007/s00520-009-0797-x

    Article  PubMed  Google Scholar 

  9. Grunberg SM, Warr D, Gralla RJ, Rapoport BL, Hesketh PJ, Jordan K, Espersen BT (2011) Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity–state of the art. Support Care Cancer 19(Suppl 1):S43–S47. doi:10.1007/s00520-010-1003-x

    Article  PubMed  Google Scholar 

  10. Hesketh PJ, Aapro M, Street JC, Carides AD (2010) Evaluation of risk factors predictive of nausea and vomiting with current standard-of-care antiemetic treatment: analysis of two phase III trials of aprepitant in patients receiving cisplatin-based chemotherapy. Support Care Cancer 18(9):1171–1177. doi:10.1007/s00520-009-0737-9

    Article  PubMed  Google Scholar 

  11. Warr DG, Street JC, Carides AD (2011) Evaluation of risk factors predictive of nausea and vomiting with current standard-of-care antiemetic treatment: analysis of phase 3 trial of aprepitant in patients receiving adriamycin-cyclophosphamide-based chemotherapy. Support Care Cancer 19(6):807–813. doi:10.1007/s00520-010-0899-5

    Article  PubMed  Google Scholar 

  12. Roscoe JA, Morrow GR, Colagiuri B, Heckler CE, Pudlo BD, Colman L, Hoelzer K, Jacobs A (2010) Insight in the prediction of chemotherapy-induced nausea. Support Care Cancer 18(7):869–876. doi:10.1007/s00520-009-0723-2

    Article  PubMed Central  PubMed  Google Scholar 

  13. Hesketh PJ (2008) Chemotherapy-induced nausea and vomiting. N Engl J Med 358(23):2482–2494. doi:10.1056/NEJMra0706547

    Article  CAS  PubMed  Google Scholar 

  14. Pirri C, Katris P, Trotter J, Bayliss E, Bennett R, Drummond P (2011) Risk factors at pretreatment predicting treatment-induced nausea and vomiting in Australian cancer patients: a prospective, longitudinal, observational study. Support Care Cancer 19(10):1549–1563. doi:10.1007/s00520-010-0982-y

    Article  PubMed  Google Scholar 

  15. Roscoe JA, Bushunow P, Morrow GR, Hickok JT, Kuebler PJ, Jacobs A, Banerjee TK (2004) Patient expectation is a strong predictor of severe nausea after chemotherapy: a University of Rochester Community Clinical Oncology Program study of patients with breast carcinoma. Cancer 101(11):2701–2708

    Article  PubMed  Google Scholar 

  16. Aapro M, Molassiotis A, Dicato M, Pelaez I, Rodriguez-Lescure A, Pastorelli D, Ma L, Burke T, Gu A, Gascon P, Roila F (2012) The effect of guideline-consistent antiemetic therapy on chemotherapy-induced nausea and vomiting (CINV): the Pan European Emesis Registry (PEER). Ann Oncol 23(8):1986–1992. doi:10.1093/annonc/mds021

    Article  CAS  PubMed  Google Scholar 

  17. Gilmore JW, Peacock NW, Gu A, Szabo S, Rammage M, Sharpe J, Haislip ST, Perry T, Boozan TL, Meador K, Cao X, Burke TA (2014) Antiemetic guideline consistency and incidence of chemotherapy-induced nausea and vomiting in US community oncology practice: INSPIRE study. J Oncol Pract 10(1):68–74. doi:10.1200/JOP.2012.000816

    Article  PubMed  Google Scholar 

  18. Molassiotis A, Aapro M, Dicato M, Gascon P, Novoa SA, Isambert N, Burke TA, Gu A, Roila F (2013) Evaluation of risk factors predicting chemotherapy-related nausea and vomiting: results from a European prospective observational study. J Pain Symptom Manag. doi:10.1016/j.jpainsymman.2013.06.012

    Google Scholar 

  19. Schwartzberg L, Szabo S, Gilmore J, Haislip S, Jackson J, Jain G, Balu S, Buchner D (2011) Likelihood of a subsequent chemotherapy-induced nausea and vomiting (CINV) event in patients receiving low, moderately or highly emetogenic chemotherapy (LEC/MEC/HEC). Curr Med Res Opin 27(4):837–845. doi:10.1185/03007995.2011.556603

    Article  PubMed  Google Scholar 

  20. Keefe D, Chan A, Kim H-K, Hsieh R-K, Yu S, Wang YC, Nicholls R, Burke TA (2014) Rationale and design of the Pan Australasian ChemoTherapy InduCed Emesis burden of illness study. Support Care Cancer. doi:10.1007/s00520-014-2374-1

  21. Yu S, Burke TA, Chan A, Kim H-K, Hsieh R-K, Hu X, Liang J-T, Banos A, Spiteri C, Keefe D (2014) Antiemetic therapy in Asia Pacific countries for patients receiving moderately and highly emetogenic chemotherapy—a description of practice patterns, antiemetic quality of care, and use of antiemetic guidelines. Support Care Cancer. doi:10.1007/s00520-014-2372-3

  22. Hsieh RK, Chan A, Kim H-K, Yu S, Kim JG, Lee M-A, Dalén J, Jung H, Liu YP, Burke TA, Keefe DMK (2014) Baseline patient characteristics, incidence of CINV, and physician perception of CINV incidence following moderately and highly emetogenic chemotherapy in Asia Pacific countries. Support Care Cancer. doi:10.1007/s00520-014-2373-2

  23. Chan A, Kim H-K, Hsieh R-K, Yu S, Lopes G, Su W-C, Banos A, Bhatia S, Burke TA, Keefe D (2014) Incidence and predictors of anticipatory CINV in Asia Pacific clinical practice – a longitudinal analysis. Support Care Cancer. doi:10.1007/s00520-014-2375-0

  24. Uppsala Monitoring Center (2010) WHO drug dictionary version 3, 01 September 2010. http://www.umc-products.com/?&mn1=1105. Accessed 24 Feb 2014

  25. Morrow GR, Roscoe JA, Hickok JT, Stern RM, Pierce HI, King DB, Banerjee TK, Weiden P (1998) Initial control of chemotherapy-induced nausea and vomiting in patient quality of life. Oncology (Williston Park) 12(3 Suppl 4):32–37

    CAS  Google Scholar 

  26. Molassiotis A, Saunders MP, Valle J, Wilson G, Lorigan P, Wardley A, Levine E, Cowan R, Loncaster J, Rittenberg C (2008) A prospective observational study of chemotherapy-related nausea and vomiting in routine practice in a UK cancer centre. Support Care Cancer 16(2):201–208. doi:10.1007/s00520-007-0343-7

    Article  CAS  PubMed  Google Scholar 

  27. Roila F (1996) Control of acute cisplatin-induced emesis over repeat courses of chemotherapy. Italian Group for Antiemetic Research. Oncology 53(Suppl 1):65–72

    Article  CAS  PubMed  Google Scholar 

  28. National Comprehensive Cancer Network (2013) NCCN clinical practice guidelines in oncology (NCCN guidelines): antiemesis, Version I.2014. http://www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf. Accessed 24 Feb 2014

  29. Basch E, Prestrud AA, Hesketh PJ, Kris MG, Feyer PC, Somerfield MR, Chesney M, Clark-Snow RA, Flaherty AM, Freundlich B, Morrow G, Rao KV, Schwartz RN, Lyman GH (2011) Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 29(31):4189–4198. doi:10.1200/JCO.2010.34.4614

    Article  PubMed  Google Scholar 

  30. Multinational Association of Supportive Care in Cancer (MASCC) (2013) MASCC/ESMO Antiemetic guideline 2013. http://www.mascc.org/assets/documents/mascc_guidelines_english_2013.pdf. Accessed 24 Feb 2014

  31. Dranitsaris G, Joy A, Young S, Clemons M, Callaghan W, Petrella T (2009) Identifying patients at high risk for nausea and vomiting after chemotherapy: the development of a practical prediction tool: I. Acute nausea and vomiting. J Support Oncol 7(4):W1–W8

    Google Scholar 

  32. Petrella T, Clemons M, Joy A, Young S, Callaghan W, Dranitsaris G (2009) Identifying patients at high risk for nausea and vomiting after chemotherapy: the development of a practical validated prediction tool: II. Delayed nausea and vomiting. J Support Oncol 7(4):W9–W16

    Google Scholar 

Download references

Acknowledgments

We thank all the investigators who participated in this study. This study was sponsored by Merck & Co., Inc. Medical writing and editorial assistance was provided by Elizabeth V. Hillyer, DVM. This assistance was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA.

Conflict of interest

AC has received remuneration, served as a consultant/advisor, and received funding from Merck Sharp & Dohme (MSD). AB is an employee of OptumInsight Inc., the Contract Research Organization that conducted the study. XY was an employee of MSD during the time of the study. TAB is an employee of Merck and may own stock or stock options. DMKK has served as a consultant/advisor for Merck, Pfizer, Soligenix, Entera, and Helsinn and has received funding from Entera and Helsinn. All remaining authors have declared no conflict of interest. The authors state that they have full control of all primary data and that they agree to allow the journal to review their data if requested.

Author information

Authors and Affiliations

  1. St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea

    Hoon-Kyo Kim

  2. Cancer Center, Mackay Memorial Hospital, Taipei, Taiwan

    RueyKuen Hsieh

  3. National University of Singapore, National Cancer Centre Singapore, Singapore, Singapore

    Alexandre Chan

  4. Cancer Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Shiying Yu

  5. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai, China

    Baohui Han

  6. Beijing Cancer Hospital, Beijing, China

    Yunong Gao

  7. OptumInsight, Inc., Stockholm, Sweden

    Ana Baños

  8. Outcomes Research, Merck Sharp & Dohme, Shanghai, China

    Xiaoyan Ying

  9. Global Health Outcomes, Merck Research Labs, Whitehouse Station, NJ, USA

    Thomas A. Burke

  10. Faculty of Health Sciences, University of Adelaide, Adelaide, Australia

    Dorothy M. K. Keefe

Authors
  1. Hoon-Kyo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. RueyKuen Hsieh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexandre Chan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shiying Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Baohui Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yunong Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ana Baños
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Xiaoyan Ying
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Thomas A. Burke
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Dorothy M. K. Keefe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas A. Burke.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(PDF 36 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, HK., Hsieh, R., Chan, A. et al. Impact of CINV in earlier cycles on CINV and chemotherapy regimen modification in subsequent cycles in Asia Pacific clinical practice. Support Care Cancer 23, 293–300 (2015). https://doi.org/10.1007/s00520-014-2376-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-014-2376-z

Keywords

Search

Navigation