A Nationwide, Multicenter Registry Study of Antiemesis for Carboplatin-Based Chemotherapy-Induced Nausea and Vomiting in Japan

Overview

Journal Oncologist

Publisher Oxford University Press

Specialty Oncology

Date 2020 Feb 12

PMID 32043774

Citations 7

Authors

Hirotoshi Iihara

Mototsugu Shimokawa

Toshinobu Hayashi

Hitoshi Kawazoe

Toshiaki Saeki

Keisuke Aiba

Kazuo Tamura

Affiliations

Soon will be listed here.

Abstract

Background: We previously reported the results of a prospective study of chemotherapy-induced nausea and vomiting (CINV) in a cohort of patients who received carboplatin-based chemotherapy and were selected from a nationwide registry of those scheduled for moderately (MEC) or highly emetogenic chemotherapy (HEC) by the CINV Study Group of Japan. Of 1,910 previously registered patients (HEC: 1,195; MEC: 715), 400 patients received carboplatin-based chemotherapy. The frequency of CINV was determined, and the risk factors for CINV were assessed.

Materials And Methods: CINV data were collected from 7-day diaries. Risk factors for CINV were identified using logistic regression models.

Results: Of 400 patients scheduled for carboplatin-based chemotherapy, 267 patients received two antiemetics (5-hydroxytryptamine-3 receptor antagonist [5-HT RA] and dexamethasone [DEX]), 118 patients received three antiemetics (5-HT RA, DEX, and neurokinin-1 receptor antagonist [NK RA]), and 15 were nonadherent to the treatment. In these patients, the CINV overall, acute, and delayed phase rates of complete response (CR), defined as no vomiting with no rescue medication, were 67.0%, 98.2%, and 67.5%, respectively. The rates of no nausea were 55.6%, 94.0%, and 56.1%, respectively, and those of no vomiting were 81.3%, 99.0%, and 81.8%, respectively. Older age was associated with a decreased non-CR, whereas female sex, history of pregnancy-related emesis, and dual antiemetic therapy were associated with an increased non-CR during the overall period.

Conclusion: In a clinical practice setting, in patients who received carboplatin-based chemotherapy, adherence is quite high and appropriate antiemetic prophylaxis requires a triple antiemetic regimen including NK RA.

Implications For Practice: For patients receiving carboplatin-based chemotherapy, triple antiemetic therapy with 5-hydroxytryptamine-3 receptor antagonist, dexamethasone, and neurokinin-1 receptor antagonist should be given prophylactically regardless of risk factor status.

Citing Articles

Defining the clinical benefits of adding a neurokinin-1 receptor antagonist to control chemotherapy-induced nausea and vomiting in moderately emetogenic chemotherapy: a systematic review and meta-analysis of the clinical practice guidelines for....

Hayashi T, Yamamoto S, Miyata Y, Takeda M, Abe M, Wada M Int J Clin Oncol. 2024; 29(11):1616-1631.

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Olanzapine Plus Triple Antiemetic Therapy for the Prevention of Carboplatin-Induced Nausea and Vomiting: A Randomized, Double-Blind, Placebo-Controlled Phase III Trial.

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PMID: 38833659 PMC: 11315403. DOI: 10.1200/JCO.24.00278.

Multi-institutional survey of antiemetic therapy in lung cancer patients treated with carboplatin in Hokushin region.

Ide T, Nishino Y, Takiguchi T, Kanda S, Otsuki K, Hayashi R BMC Pulm Med. 2023; 23(1):228.

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One-Day Versus Three-Day Dexamethasone with NK1RA for Patients Receiving Carboplatin and Moderate Emetogenic Chemotherapy: A Network Meta-analysis.

Watanabe D, Iihara H, Fujii H, Makiyama A, Nishida S, Suzuki A Oncologist. 2022; 27(6):e524-e532.

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Effects of adding a neurokinin-1 receptor antagonist to 5 mg olanzapine, a 5-hydroxytryptamine-3 receptor antagonist, and dexamethasone for preventing carboplatin-induced nausea and vomiting: a propensity score-matched analysis.

Yamamoto S, Iihara H, Uozumi R, Kawazoe H, Tanaka K, Fujita Y BMC Cancer. 2022; 22(1):310.

PMID: 35321690 PMC: 8941806. DOI: 10.1186/s12885-022-09392-9.

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