Prediction of chemotherapy-induced nausea and vomiting from patient-reported and genetic risk factors
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.
KeywordsChemotherapy 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.
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 was obtained from all individual participants included in the study.
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