Supportive Care in Cancer

, Volume 26, Issue 8, pp 2911–2918 | Cite as

Prediction of chemotherapy-induced nausea and vomiting from patient-reported and genetic risk factors

  • Sonam Puri
  • Kelly A. Hyland
  • Kristine Crowe Weiss
  • Gillian C. Bell
  • Jhanelle E. Gray
  • Richard Kim
  • Hui-Yi Lin
  • Aasha I. Hoogland
  • Brian D. Gonzalez
  • Ashley M. Nelson
  • Anita Y. Kinney
  • Stacy M. Fischer
  • Daneng Li
  • Paul B. Jacobsen
  • Howard L. McLeod
  • Heather S. L. JimEmail author
Original Article



Chemotherapy-induced nausea and vomiting (CINV) is common among cancer patients. Early identification of patients at risk for CINV may help to personalize anti-emetic therapies. To date, few studies have examined the combined contributions of patient-reported and genetic risk factors to CINV. The goal of this study was to evaluate these risk factors.


Prior to their first chemotherapy infusion, participants completed demographic and risk factor questionnaires and provided a blood sample to measure genetic variants in ABCB1 (rs1045642) and HTR3B (rs45460698) as well as CYP2D6 activity score. The M.D. Anderson Symptom Inventory was completed at 24 h and 5-day post-infusion to assess the severity of acute and delayed CINV, respectively.


Participants were 88 patients (55% female, M = 60 years). A total of 23% experienced acute nausea and 55% delayed nausea. Younger age, history of pregnancy-related nausea, fewer hours slept the night prior to infusion, and variation in ABCB1 were associated with more severe acute nausea; advanced-stage cancer and receipt of highly emetogenic chemotherapy were associated with more severe delayed nausea (p values < 0.05). In multivariable analyses, ABCB1 added an additional 5% predictive value beyond the 13% variance explained by patient-reported risk factors.


The current study identified patient-reported and genetic factors that may place patients at risk for acute nausea despite receipt of guideline-consistent anti-emetic prophylaxis. Additional studies examining other genetic variants are needed, as well as the development of risk prediction models including both patient-reported and genetic risk factors.


Chemotherapy Neoplasms Nausea Vomiting Risk factors Genetic variation 



Funding was provided by the Moffitt Cancer Center Team Science Award (PIs: Jim, McLeod). This work was supported in part by the Survey Methods Core and the Tissue Core Facilities at the H. Lee Moffitt Cancer Center & Research Institute, an NCI-designated Comprehensive Cancer Center (P30 CA076292).

Compliance with ethical standards

This manuscript describes original work and is not under consideration by any other journal. We have adhered to the journals submission requirements. We have full control of all primary data and we agree to allow the journal to review the data if requested. All authors approve the manuscript and its submission.

Conflict of interest

Dr. Li is a consultant for Novartis. Dr. Jim is a consultant for RedHill Biopharma. This work was performed while Dr. Jacobsen was at the Moffitt Cancer Center and does not represent the views of the National Cancer Institute.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by ant of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Sonam Puri
    • 1
    • 2
  • Kelly A. Hyland
    • 3
    • 4
  • Kristine Crowe Weiss
    • 3
  • Gillian C. Bell
    • 5
  • Jhanelle E. Gray
    • 1
  • Richard Kim
    • 1
  • Hui-Yi Lin
    • 6
  • Aasha I. Hoogland
    • 3
  • Brian D. Gonzalez
    • 3
  • Ashley M. Nelson
    • 3
    • 4
  • Anita Y. Kinney
    • 7
  • Stacy M. Fischer
    • 8
  • Daneng Li
    • 9
  • Paul B. Jacobsen
    • 10
  • Howard L. McLeod
    • 5
  • Heather S. L. Jim
    • 3
    Email author
  1. 1.Department of Hematology and Oncology, Moffitt Cancer CenterTampaUSA
  2. 2.College of MedicineUniversity of South FloridaTampaUSA
  3. 3.Department of Health Outcomes and Behavior, Moffitt Cancer CenterTampaUSA
  4. 4.Department of PsychologyUniversity of South FloridaTampaUSA
  5. 5.Department of Cancer Epidemiology, Moffitt Cancer CenterTampaUSA
  6. 6.Department of Biostatistics and Bioinformatics, Moffitt Cancer CenterTampaUSA
  7. 7.Department of Internal MedicineUniversity of New MexicoAlbuquerqueUSA
  8. 8.Division of General Internal MedicineUniversity of Colorado School of MedicineDenverUSA
  9. 9.Department of Medical Oncology and Therapeutics ResearchDuarteUSA
  10. 10.Healthcare Delivery Research Program, National Cancer InstituteBethesdaUSA

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