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Risk factors of chemotherapy-induced nausea and vomiting in patients with metastatic colorectal cancer: a prospective cohort study (YCOG1301)

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Although the effectiveness of antiemetic therapy for colorectal cancer chemotherapy has improved with further drug development, some patients still suffer from chemotherapy-induced nausea and vomiting (CINV) even with only 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. The present study investigated the risk factors of CINV in patients who received chemotherapy for colorectal cancer and clarified which patients need additional neurokinin 1 receptor antagonist.

Methods

Patients with colorectal cancer receiving moderate-emetic-risk chemotherapy (MEC) were enrolled in this prospective single-arm study with intravenous palonosetron 0.75 mg and dexamethasone 9.9 mg before chemotherapy and with paroral dexamethasone 8 mg on days 2 and 3. The primary endpoint was the complete response (CR) rate for delayed-phase CINV.

Results

A total of 179 patients were eligible for this study. The delayed CR rate was 84.9% (152/179). There were no significant differences in any risk factors, but women with a low body mass index (BMI) (a combination of “female sex” and “BMI < 20”) showed a significantly lower rate of CC (complete control) (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.17–1.13; p = 0.039), and young patients with a low BMI (combination of “age < 65” and “BMI < 20”) showed a significantly lower rate of CR (OR = 0.34, 95% CI = 0.13–0.88; p = 0.022) than the other patients.

Conclusions

This study failed to identify any single risk factors associated with delayed CINV in patients who received chemotherapy for advanced colorectal cancer. However, combinations of “thin and women” or “young and thin patients” might be possible predictive conditions, thus, candidates for NK1 receptor antagonist administration in MEC. Further investigations are required to develop criteria for the supplementation of NK1 receptor antagonist.

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Acknowledgments

The authors thank all the members of the institutions participating in the “YCOG 1301” project: Masashi Momiyama (NTT Medical Center Tokyo); Hidenobu Masui (Yokosuka Kyosai Hospital); Yasuhisa Mochizuki (Yokohama Municipal Citizen’s Hospital); Shigeru Yamagishi (Fujisawa Municipal Citizen’s Hospital); Tadao Fukushima (Saiseikai Yokohama Nanbu Hospital); Hitoshi Sekido (National Hospital Organization Yokohama Medical Center); Mitsutaka Sugita (Yokohama City Minato Red Cross Hospital); Nobuyuki Kamimukai (Yokohama Hodogaya Central Hospital); Kunio Kameda (Yokosuka Municipal Citizen’s Hospital); and Daisuke Morioka (Yokohama Ekisaikai Hospital).

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Shogo Takei, Atsushi Ishibe, Kazuteru Watanabe, Shinsuke Suzuki, Kazuya Nakagawa & Itaru Endo

  2. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan

    Jun Watanabe, Yusuke Suwa & Chikara Kunisaki

  3. Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan

    Hirokazu Suwa

  4. Department of Surgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan

    Mitsuyoshi Ota

  5. Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Yasushi Ichikawa

  6. Department of Biostatistics and Epidemiology, Yokohama City University, Yokohama, Japan

    Takeharu Yamanaka

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  1. Shogo Takei
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  2. Atsushi Ishibe
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  3. Jun Watanabe
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  6. Shinsuke Suzuki
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  7. Kazuya Nakagawa
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  8. Hirokazu Suwa
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  9. Mitsuyoshi Ota
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  10. Yasushi Ichikawa
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  12. Takeharu Yamanaka
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  13. Itaru Endo
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Corresponding author

Correspondence to Atsushi Ishibe.

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The authors declare that they have no conflict of interest.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Yokohama City University (No. D1304001).

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

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Takei, S., Ishibe, A., Watanabe, J. et al. Risk factors of chemotherapy-induced nausea and vomiting in patients with metastatic colorectal cancer: a prospective cohort study (YCOG1301). Int J Colorectal Dis 35, 2323–2329 (2020). https://doi.org/10.1007/s00384-020-03731-7

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  • DOI: https://doi.org/10.1007/s00384-020-03731-7

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