Primary versus secondary antiemetic prophylaxis with NK1 receptor antagonists in patients affected by gastrointestinal malignancies and treated with a doublet or triplet combination regimen including oxaliplatin and/or irinotecan plus fluoropyrimidines: A propensity score matched analysis.

Autor:	Parisi A; Clinica Oncologica e Centro Regionale di Genetica Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti-Ancona, Ancona, Italy.; Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy., Giampieri R; Clinica Oncologica e Centro Regionale di Genetica Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti-Ancona, Ancona, Italy., Mammarella A; Clinica Oncologica e Centro Regionale di Genetica Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti-Ancona, Ancona, Italy., Felicetti C; Clinica Oncologica e Centro Regionale di Genetica Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti-Ancona, Ancona, Italy., Salvatore L; Università Cattolica del Sacro Cuore, Rome, Italy.; Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy., Bensi M; Università Cattolica del Sacro Cuore, Rome, Italy.; Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy., Maratta MG; Università Cattolica del Sacro Cuore, Rome, Italy.; Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy., Strippoli A; Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy., Filippi R; Department of Oncology, University of Turin, Torino, Italy.; S.C Oncologia Medica 1, Centro Oncologico Ematologico Subalpino (COES), Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Torino, Italy., Satolli MA; Department of Oncology, University of Turin, Torino, Italy.; S.C Oncologia Medica 1, Centro Oncologico Ematologico Subalpino (COES), Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Torino, Italy., Petrillo A; Medical Oncology Unit, Ospedale del Mare, Naples, Italy., Daniele B; Medical Oncology Unit, Ospedale del Mare, Naples, Italy., De Tursi M; Department of Medical, Oral and Biotechnological Sciences and Center for Advance Studies and Technology (CAST), G. D'Annunzio University, Chieti, Italy.; Clinical Oncology Unit, S.S. Annunziata Hospital, Chieti, Italy., Di Marino P; Department of Medical, Oral and Biotechnological Sciences and Center for Advance Studies and Technology (CAST), G. D'Annunzio University, Chieti, Italy.; Clinical Oncology Unit, S.S. Annunziata Hospital, Chieti, Italy., Giordano G; Medical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy., Landriscina M; Medical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy., Vitale P; Medical Oncology Unit, Santa Chiara Hospital, Trento, Italy., Zurlo IV; Medical Oncology, 'Vito Fazzi' Hospital, Lecce, Italy., Dell'Aquila E; Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome, Italy., Tomao S; Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I, 'Sapienza' University of Rome, Rome, Italy., Depetris I; Medical Oncology, ASL TO4, Ospedale Civile di Ivrea, Turin, Italy., Di Pietro FR; Istituto Dermopatico dell'Immacolata (IDI), IRCCS, Rome, Italy., Zoratto F; Medical Oncology, Santa Maria Goretti Hospital, Latina, Italy., Ciardiello D; Oncology Unit, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy.; Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Pensieri MV; Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy., Garrone O; Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy., Galassi B; Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy., Ferri C; Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy., Berardi R; Clinica Oncologica e Centro Regionale di Genetica Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti-Ancona, Ancona, Italy., Ghidini M; Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2022 Aug 12; Vol. 12, pp. 935826. Date of Electronic Publication: 2022 Aug 12 (Print Publication: 2022).
DOI:	10.3389/fonc.2022.935826
Abstrakt:	Aim: The aim of the current study is to investigate the impact of primary compared to secondary chemotherapy-induced nausea and vomiting (CINV) prophylaxis with NK1 receptor antagonists (NK1-RA) in patients affected by gastrointestinal malignancies and treated with oxaliplatin- and/or irinotecan-based doublet or triplet regimens. Study Design and Methods: Clinical data of patients affected by gastrointestinal malignancies, treated with an oxaliplatin and/or irinotecan-based doublet or triplet regimen as neo/adjuvant or advanced-line treatment, and who received NK1-RA as primary (from the first cycle of treatment) or secondary (after the onset of CINV with a previous regimen with 5HT3-RA and dexamethasone) prophylaxis for CINV, were retrospectively collected in an observational study involving 16 Italian centers. A propensity score matching was performed by taking into account the following stratification factors: sex (male vs. female), age (< vs. ≥70 years old), overweight (body mass index, BMI < vs. ≥25), underweight (BMI < vs. ≥19), disease spread (early vs. advanced/metastatic), tumor type (esophagogastric cancer vs. the rest, hepatobiliary tumor vs. the rest, colorectal cancer vs. the rest), type of NK1-RA used as primary/secondary prophylaxis (netupitant-palonosetron vs. fosaprepitant/aprepitant), concomitant use of opioids (yes vs. no), concomitant use of antidepressant/antipsychotic drugs (yes vs. no), Eastern Cooperative Oncology Group (ECOG) performance status at the start of NK1-RA treatment (0 vs. 1-2), and intensity of chemotherapy regimen (doublet vs. triplet). Results: Among 409 patients included from January 2015 to January 2022 and eligible for analysis, 284 (69%) and 125 (31%) were treated with NK1-RA as primary and secondary antiemetic prophylaxis, respectively. After matching, primary NK1-RA use was not associated with higher rates of protection from emesis regardless the emesis phase (acute phase, p = 0.34; delayed phase, p = 0.14; overall phase, p = 0.80). On the other hand, a lower rate of relevant nausea (p = 0.02) and need for rescue antiemetic therapy (p = 0.000007) in the overall phase was found in primary NK1-RA users. Furthermore, a higher rate of both complete antiemetic response (p = 0.00001) and complete antiemetic protection (p = 0.00007) in the overall phase was more frequently observed in primary NK1-RA users. Finally, chemotherapy delays (p = 0.000009) and chemotherapy dose reductions (p = 0.0000006) were less frequently observed in primary NK1-RA users. Conclusion: In patients affected by gastrointestinal malignancies, a primary CINV prophylaxis with NK1-RA, 5HT3-RA, and dexamethasone might be appropriate, particularly in those situations at higher risk of emesis and in which it is important to avoid dose delays and/or dose reductions, keeping a proper dose intensity of chemotherapy drugs. Competing Interests: APa reported receiving advisory board fees from GSK, Servier, Pharmamar. RG reported receiving fees from Amgen and Servier and advisory board fees from Amgen, Servier, Bayer and Merck-Serono. LS reported receiving fees from Pierre-Fabre, AstraZeneca, Bayer, Servier, Merck, Amgen. APe reported receiving fees from Eli-Lilly, MSD, BMS, Merck, Servier. BD has received fees from Ipsen, Eisai, Eli Lilly, AstraZeneca, Sanofi, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, Bayer, Roche, and Amgen; and has received non-financial support from Ipsen, BMS. MG reported receiving fees by Amgen, Merck, Eli-Lilly, Servier, Italfarmaco. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Parisi, Giampieri, Mammarella, Felicetti, Salvatore, Bensi, Maratta, Strippoli, Filippi, Satolli, Petrillo, Daniele, De Tursi, Di Marino, Giordano, Landriscina, Vitale, Zurlo, Dell’Aquila, Tomao, Depetris, Di Pietro, Zoratto, Ciardiello, Pensieri, Garrone, Galassi, Ferri, Berardi and Ghidini.)
Databáze:	MEDLINE
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