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

The oncologist

article

Hirotoshi Iihara¹  Mototsugu Shimokawa³  Toshinobu Hayashi⁴  Hitoshi Kawazoe⁵  Toshiaki Saeki⁶  Keisuke Aiba⁷  Kazuo Tamura⁸ 

[1] Department of Pharmacy, Gifu University Hospital;Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University;Cancer Biostatistics Laboratory, National Hospital Organization Kyushu Cancer Center;Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University;Division of Pharmaceutical Care Sciences, Center for Social Pharmacy and Pharmaceutical Care Sciences, Keio University Faculty of Pharmacy;Saitama Medical University International Medical Center;Division of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University School of Medicine;General Medical Research Center, Fukuoka University School of Medicine

关键词: Antiemetic;    Carboplatin;    Chemotherapy;    Nausea;    Risk factor;    Vomiting;   

DOI  :  10.1634/theoncologist.2019-0292

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

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 3 RA] and dexamethasone [DEX]), 118 patients received three antiemetics (5-HT 3 RA, DEX, and neurokinin-1 receptor antagonist [NK 1 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 1 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.

【 授权许可】

CC BY|CC BY-NC