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A prospective, observational, multicenter study on risk factors and prophylaxis for low emetic risk chemotherapy-induced nausea and vomiting

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Abstract

Purpose

The incidence of and the risk factors for nausea and vomiting in patients undergoing low emetic risk chemotherapy (LEC) are unclear. The aim of the study was to provide information on these topics by performing a multicenter, observational, prospective study.

Methods

The study consisted of patients who were administered first-time LEC that was consistent or inconsistent with current guidelines. Using the visual analog scale, patients recorded their daily food intake and the occurrence and severity of nausea over a 5-day treatment period.

Results

The overall incidence of chemotherapy-induced nausea and vomiting did not differ significantly between patients undergoing guideline-consistent (n = 89) or guideline-inconsistent (n = 121) prophylaxis (30.3 vs. 22.3%, respectively; P = 0.19). Logistic regression analysis identified a history of nausea and LEC other than taxanes as independent risk factors associated with nausea and vomiting in patients undergoing LEC. The mean daily visual analog scale scores for nausea severity and a decrease in food intake were <25 mm throughout the entire observation period.

Conclusions

Guideline-consistent prophylaxis appeared to control nausea and vomiting effectively in patients undergoing LEC. However, patients with a history of nausea and receiving LEC other than taxanes should be carefully observed and treatment should be adjusted according to their symptoms.

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References

  1. Olver I, Ruhlmann CH, Jahn F, Schwartzberg L, Rapoport B, Rittenberg CN, Clark-Snow R (2016) 2016 updated MASCC/ESMO consensus recommendations: controlling nausea and vomiting with chemotherapy of low or minimal emetic potential supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

  2. 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. Journal of Clinical Oncology : official journal of the American Society of Clinical Oncology 29:4189–4198

    Article  Google Scholar 

  3. NCCN (2015) NCCN clinical practice guidelines in oncology (2014) Antiemetics. Version 2 NCCN

  4. Japan Society of Clinical Oncology (2010) Guidelines for appropriate use of antiemetic drugs, version 1. Kanehara, Tokyo

  5. Burmeister H, Aebi S, Studer C, Fey MF, Gautschi O (2012) Adherence to ESMO clinical recommendations for prophylaxis of chemotherapy-induced nausea and vomiting. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 20:141–147

    Article  Google Scholar 

  6. Hayashi T, Ikesue H, Esaki T, Fukazawa M, Abe M, Ohno S, Tomizawa T, Oishi R (2012) Implementation of institutional antiemetic guidelines for low emetic risk chemotherapy with docetaxel: a clinical and cost evaluation. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 20:1805–1810

    Article  Google Scholar 

  7. Italian Group For Antiemetic R (2004) Randomized, double-blind, dose-finding study of dexamethasone in preventing acute emesis induced by anthracyclines, carboplatin, or cyclophosphamide. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 22:725–729

    Article  Google Scholar 

  8. 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. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer 16:201–208

    Article  CAS  Google Scholar 

  9. Tonato M, Clark-Snow RA, Osoba D, Del Favero A, Ballatori E, Borjeson S (2005) Emesis induced by low or minimal emetic risk chemotherapy. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer 13:109–111

    Article  Google Scholar 

  10. Seynaeve CVJ, de Mulder PH (1991) 5-HT3 receptor antagonists, a new approach in emesis: a review of ondansetron, granisetron and tropisetron. Anti-Cancer Drugs 2:343–355

    Article  CAS  PubMed  Google Scholar 

  11. Vardy J, Chiew KS, Galica J, Pond GR, Tannock IF (2006) Side effects associated with the use of dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy. British journal of cancer 94:1011–1015

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. du Bois A, Meerpohl HG, Vach W, Kommoss FG, Fenzl E, Pfleiderer A (1992) Course, patterns, and risk-factors for chemotherapy-induced emesis in cisplatin-pretreated patients: a study with ondansetron. European journal of cancer 28:450–457

    Article  PubMed  Google Scholar 

  13. Hesketh P, Navari R, Grote T, Gralla R, Hainsworth J, Kris M, Anthony L, Khojasteh A, Tapazoglou E, Benedict C, Hahne W (1996) Double-blind, randomized comparison of the antiemetic efficacy of intravenous dolasetron mesylate and intravenous ondansetron in the prevention of acute cisplatin-induced emesis in patients with cancer. Dolasetron Comparative Chemotherapy-induced Emesis Prevention Group. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 14:2242–2249

    Article  CAS  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. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 15:116–123

    Article  CAS  Google Scholar 

  15. Pater J, Slamet L, Zee B, Osoba D, Warr D, Rusthoven J (1994) Inconsistency of prognostic factors for post-chemotherapy nausea and vomiting. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2:161–166

    Article  CAS  Google Scholar 

  16. Pollera CF, Giannarelli D (1989) Prognostic factors influencing cisplatin-induced emesis. Definition and validation of a predictive logistic model Cancer 64:1117–1122

    CAS  PubMed  Google Scholar 

  17. Research IGfA (1995) Persistence of efficacy of three antiemetic regimens and prognostic factors in patients undergoing moderately emetogenic chemotherapy. Italian Group for Antiemetic Research. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 13:2417–2426

    Article  Google Scholar 

  18. Roila F, Boschetti E, Tonato M, Basurto C, Bracarda S, Picciafuoco M, Patoia L, Santi E, Penza O, Ballatori E et al (1991) Predictive factors of delayed emesis in cisplatin-treated patients and antiemetic activity and tolerability of metoclopramide or dexamethasone. A randomized single-blind study. American journal of clinical oncology 14:238–242

    Article  CAS  PubMed  Google Scholar 

  19. Roila F, Tonato M, Basurto C, Bella M, Passalacqua R, Morsia D, DiCostanzo F, Donati D, Ballatori E, Tognoni G et al (1987) Antiemetic activity of high doses of metoclopramide combined with methylprednisolone versus metoclopramide alone in cisplatin-treated cancer patients: a randomized double-blind trial of the Italian Oncology Group for Clinical Research. Journal of clinical oncology: official journal of the American Society of Clinical Oncology 5:141–149

    Article  CAS  Google Scholar 

  20. 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 International journal of clinical oncology

  21. Hesketh PJ, Grunberg SM, Gralla RJ, Warr DG, Roila F, de Wit R, Chawla SP, Carides AD, Ianus J, Elmer ME, Evans JK, Beck K, Reines S, Horgan KJ ((2003)) The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin—the Aprepitant Protocol 052 Study Group. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 21:4112–4119

    Article  CAS  Google Scholar 

  22. Molassiotis A, Aapro M, Dicato M, Gascon P, Novoa SA, Isambert N, Burke TA, Gu A, Roila F (2014) Evaluation of risk factors predicting chemotherapy-related nausea and vomiting: results from a European prospective observational study. Journal of pain and symptom management 47:839–848 e834

    Article  PubMed  Google Scholar 

  23. Molassiotis A, Yam BM, Yung H, Chan FY, Mok TS (2002) Pretreatment factors predicting the development of postchemotherapy nausea and vomiting in Chinese breast cancer patients. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer 10:139–145

    Article  CAS  Google Scholar 

  24. 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. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer 19:1549–1563

    Article  Google Scholar 

  25. Keat CH, Phua G, Abdul Kassim MS, Poh WK, Sriraman M (2013) Can granisetron injection used as primary prophylaxis improve the control of nausea and vomiting with low-emetogenic chemotherapy? Asian Pacific journal of cancer prevention : APJCP 14:469–473

    Article  PubMed  Google Scholar 

  26. Schwartzberg L, Morrow G, Balu S, Craver C, Gayle J, Cox D ((2011)) Chemotherapy-induced nausea and vomiting and antiemetic prophylaxis with palonosetron versus other 5-HT3 receptor antagonists in patients with cancer treated with low emetogenic chemotherapy in a hospital outpatient setting in the United States. Current medical research and opinion 27:1613–1622

    Article  CAS  PubMed  Google Scholar 

  27. Hesketh PJ, Morrow G, Komorowski AW, Ahmed R, Cox D (2012) Efficacy and safety of palonosetron as salvage treatment in the prevention of chemotherapy-induced nausea and vomiting in patients receiving low emetogenic chemotherapy (LEC). Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 20:2633–2637

    Article  Google Scholar 

  28. Roscoe JA, Morrow GR, Aapro MS, Molassiotis A, Olver I (2011) Anticipatory nausea and vomiting. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 19:1533–1538

    Article  Google Scholar 

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Acknowledgments

We thank the study participants and their families and the support personnel. This study included the following 13 medical institutions: the National Kyushu Medical Center (Fukuoka, Fukuoka), National Kyushu Cancer Center (Fukuoka, Fukuoka), National Hospital Organization (NHO) Fukuoka National Hospital (Fukuoka, Fukuoka), NHO Kokura Medical Center (Kitakyushu, Fukuoka), NHO Saga National Hospital (Saga, Saga), NHO Ureshino Medical Center (Ureshino, Saga), NHO Nagasaki Medical Center (Omura, Nagasaki), NHO Kumamoto Medical Center (Kumamoto, Kumamoto), NHO Kumamoto Saishunso National Hospital (Koushi, Kumamoto), NHO Kumamoto Minami National Hospital (Uki, Kumamoto), NHO Beppu Medical Center (Beppu, Oita), NHO Miyakonojo Medical Center (Miyakonojo, Miyazaki), and NHO Kagoshima Medical Center (Kagoshima, Kagoshima).

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Correspondence to Toshinobu Hayashi.

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Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

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

Funding source

This work was supported by the Policy-based Medical Service Foundation.

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Hayashi, T., Shimokawa, M., Miyoshi, T. et al. A prospective, observational, multicenter study on risk factors and prophylaxis for low emetic risk chemotherapy-induced nausea and vomiting. Support Care Cancer 25, 2707–2714 (2017). https://doi.org/10.1007/s00520-017-3679-7

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  • DOI: https://doi.org/10.1007/s00520-017-3679-7

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