Open AccessA Nationwide, Multicenter Registry Study of Antiemesis for Carboplatin‐Based Chemotherapy‐Induced Nausea and Vomiting in Japan
Author(s) -
Iihara Hirotoshi,
Shimokawa Mototsugu,
Hayashi Toshinobu,
Kawazoe Hitoshi,
Saeki Toshiaki,
Aiba Keisuke,
Tamura Kazuo
Publication year - 2020
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2019-0292
Subject(s) - medicine , carboplatin , chemotherapy induced nausea and vomiting , nausea , vomiting , antiemetic , chemotherapy , anesthesia , cisplatin
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.