Skip to main content

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

International Journal of Colorectal Disease volume 35, pages 2323–2329 (2020)Cite this article

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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

Data availability

Not applicable.

References

  1. Lindley CM, Hirsch JD, O’Neill CV, Transau MC, Gilbert CS, Osterhaus JT (1992) Quality of life consequences of chemotherapy-induced emesis. Qual Life Res 1(5):331–340. https://doi.org/10.1007/bf00434947

    CAS  Article  PubMed  Google Scholar 

  2. Morita S, Kobayashi K, Eguchi K, Matsumoto T, Shibuya M, Yamaji Y, Sakamoto J, Ohashi Y (2003) Influence of clinical parameters on quality of life during chemotherapy in patients with advanced non-small cell lung cancer: application of a general linear model. Jpn J Clin Oncol 33(9):470–476. https://doi.org/10.1093/jjco/hyg083

    Article  PubMed  Google Scholar 

  3. Ioannidis JP, Hesketh PJ, Lau J (2000) Contribution of dexamethasone to control of chemotherapy-induced nausea and vomiting: a meta-analysis of randomized evidence. J Clin Oncol 18(19):3409–3422

    CAS  Article  PubMed  Google Scholar 

  4. Hesketh PJ, Kris MG, Basch E, Bohlke K, Barbour SY, Clark-Snow RA, Danso MA, Dennis K, Dupuis LL, Dusetzina SB, Eng C, Feyer PC, Jordan K, Noonan K, Sparacio D, Somerfield MR, Lyman GH (2017) Antiemetics: American Society of Clinical Oncology Clinical Practice guideline update. J Clin Oncol 35(28):3240–3261. https://doi.org/10.1200/jco.2017.74.4789

    CAS  Article  PubMed  Google Scholar 

  5. NCCN Clinical Practice Guidelines in Oncology-Antiemesis- (2019) https://www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf.

  6. Oncology JSoC (2015) Guidelines for appropriate use of antiemetic drugs, Version 2. Kanehara Tokyo,

  7. Roila F, Copenhagen obotpotMECC, Molassiotis A, Copenhagen obotpot MECC, Herrstedt J, Copenhagen obotpotMECC, Aapro M, Copenhagen obotpotMECC, Gralla RJ, Copenhagen obotpotMECC, Bruera E, Copenhagen obotpotMECC, Clark-Snow RA, Copenhagen obotpotMECC, Dupuis LL, Copenhagen obotpotMECC, Einhorn LH, Copenhagen obotpotMECC, Feyer P, Copenhagen obotpotMECC, Hesketh PJ, Copenhagen obotpotMECC, Jordan K, Copenhagen obotpotMECC, Olver I, Copenhagen obotpotMECC, Rapoport BL, Copenhagen obotpotMECC, Roscoe J, Copenhagen obotpotMECC, Ruhlmann CH, Copenhagen obotpotMECC, Walsh D, Copenhagen obotpotMECC, Warr D, Copenhagen obotpotMECC, van der Wetering M, Copenhagen obotpotMECC (2016) 2016 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting and of nausea and vomiting in advanced cancer patients. Ann Oncol 27(suppl_5):v119–v133. https://doi.org/10.1093/annonc/mdw270

    CAS  Article  PubMed  Google Scholar 

  8. NCCN Clinical Practice Guidelines in Oncology-Colon Cancer- (2019) https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf. Accessed Jun 24 2019

  9. NCCN Clinical Practice Guidelines in Oncology-Rectal Cancer- (2019) https://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf. Accessed Jun 24 2019

  10. Tamura K, Aiba K, Saeki T, Nakanishi Y, Kamura T, Baba H, Yoshida K, Yamamoto N, Kitagawa Y, Maehara Y, Shimokawa M, Hirata K, Kitajima M, Japan CSGo (2015) Testing the effectiveness of antiemetic guidelines: results of a prospective registry by the CINV Study Group of Japan. Int J Clin Oncol 20(5):855–865. https://doi.org/10.1007/s10147-015-0786-7

    Article  PubMed  Google Scholar 

  11. Warr D (2014) Prognostic factors for chemotherapy induced nausea and vomiting. Eur J Pharmacol 722:192–196. https://doi.org/10.1016/j.ejphar.2013.10.015

    CAS  Article  PubMed  Google Scholar 

  12. Takemoto H, Nishimura J, Komori T, Kim HM, Ota H, Suzuki R, Ikenaga M, Ikeda M, Yamamoto H, Satoh T (2017) Combination antiemetic therapy with aprepitant/fosaprepitant in patients with colorectal cancer receiving oxaliplatin-based chemotherapy in the SENRI trial: analysis of risk factors for vomiting and nausea. Int J Clin Oncol 22(1):88–95

    CAS  Article  PubMed  Google Scholar 

  13. Hayashi M, Nakazawa K, Hasegawa Y, Horiguchi J, Miura D, Ishikawa T, Takao S, Kim SJ, Yamagami K, Miyashita M, Konishi M, Shigeoka Y, Suzuki M, Taguchi T, Kubota T, Tanino H, Yamada K, Narui K, Kimura K, Akazawa K, Kohno N, Group JS (2019) Risk analysis for chemotherapy-induced nausea and vomiting (CINV) in patients receiving FEC100 treatment. Anticancer Res 39(8):4305–4314. https://doi.org/10.21873/anticanres.13596

    CAS  Article  PubMed  Google Scholar 

  14. Osoba D, Zee B, Pater J, Warr D, Latreille J, Kaizer L (1997) Determinants of postchemotherapy nausea and vomiting in patients with cancer. Quality of Life and Symptom Control Committees of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 15(1):116–123. https://doi.org/10.1200/jco.1997.15.1.116

    CAS  Article  PubMed  Google Scholar 

  15. Sekine I, Segawa Y, Kubota K, Saeki T (2013) Risk factors of chemotherapy-induced nausea and vomiting: index for personalized antiemetic prophylaxis. Cancer Sci 104(6):711–717. https://doi.org/10.1111/cas.12146

    CAS  Article  PubMed  Google Scholar 

  16. 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. https://doi.org/10.1007/s00520-010-0899-5

    Article  PubMed  Google Scholar 

  17. Dranitsaris G, Molassiotis A, Clemons M, Roeland E, Schwartzberg L, Dielenseger P, Jordan K, Young A, Aapro M (2017) The development of a prediction tool to identify cancer patients at high risk for chemotherapy-induced nausea and vomiting. Ann Oncol 28(6):1260–1267. https://doi.org/10.1093/annonc/mdx100

    CAS  Article  PubMed  PubMed Central  Google Scholar 

Download references

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).

Code availability

Not applicable.

Author information

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

Authors
  1. Shogo Takei
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Atsushi Ishibe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jun Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazuteru Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yusuke Suwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shinsuke Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kazuya Nakagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hirokazu Suwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mitsuyoshi Ota
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yasushi Ichikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Chikara Kunisaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Takeharu Yamanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Itaru Endo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Atsushi Ishibe.

Ethics declarations

Conflict of interest

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).

Consent to participate

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

Consent for publication

Not applicable.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Accepted:

  • Published:

  • Issue Date:

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

Keywords

  • Colorectal cancer
  • CINV
  • Risk factor