5-Hydroxytryptamine-3 receptor antagonist and dexamethasone as prophylaxis for chemotherapy-induced nausea and vomiting during moderately emetic chemotherapy for solid tumors: a multicenter, prospective, observational study

Autor: Takashi Seto, Masashi Kimura, Y. Kogure, Kenichi Suzuki, Toshinobu Hayashi, Mototsugu Shimokawa, Tomomi Takiguchi, Takeshi Koike, Satoru Shimizu, Makoto Nishio, Reiko Matsui, Tomohiko Harada, Kimiko Fujiwara, Naoyuki Nogami, Hirotsugu Kenmotsu, Koichi Goto, Hiroyasu Kaneda
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Colorectal cancer
medicine.medical_treatment
NK-1 receptor antagonist
Gastroenterology
Dexamethasone
Carboplatin
Moderate emetic risk chemotherapy (MEC)
chemistry.chemical_compound
0302 clinical medicine
Neoplasms
Serotonin 5-HT3 Receptor Antagonists
Pharmacology (medical)
Etoposide
Aged
80 and over
0303 health sciences
Nausea
Middle Aged
Oxaliplatin
030220 oncology & carcinogenesis
Vomiting
Female
medicine.symptom
medicine.drug
Research Article
Adult
medicine.medical_specialty
Paclitaxel
medicine.drug_class
5-HT3 receptor antagonist
Antineoplastic Agents
03 medical and health sciences
lcsh:RA1190-1270
Internal medicine
medicine
Antiemetic
Humans
Capecitabine
lcsh:Toxicology. Poisons
030304 developmental biology
Aged
Pharmacology
Chemotherapy
Antiemetic therapy
business.industry
lcsh:RM1-950
medicine.disease
lcsh:Therapeutics. Pharmacology
chemistry
Chemotherapy-induced nausea and vomiting (CINV)
Antiemetics
Pre-Exposure Prophylaxis
business
Chemotherapy-induced nausea and vomiting
Zdroj: BMC Pharmacology & Toxicology
BMC Pharmacology and Toxicology, Vol 21, Iss 1, Pp 1-10 (2020)
ISSN: 2050-6511
Popis: Background Of patients receiving moderate emetic risk chemotherapy (MEC), 30–90% experience chemotherapy-induced nausea and vomiting (CINV); however, the optimal antiemetic treatment remains controversial. Methods In this multicenter, prospective, observational study of adults treated with MEC while receiving chemotherapy for various cancer types in Japan, the enrolled patients kept diaries documenting CINV. All participants received a 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. Results Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The median age was 64 (range, 26–84). The overall complete response (CR; no emetic events and no antiemetic measures) rate was 64%. The proportion of patients showing CR was low in the carboplatin (CBDCA)- and oxaliplatin-based chemotherapy groups, especially among women. We showed that the CR rates in men were high in the CBDCA (AUC5) + etoposide (ETP) (80%), capecitabine plus oxaliplatin (CAPOX) (78%), and CBDCA+ paclitaxel (PTX) groups for lung cancer (73%). Total control (TC; no emetic events, no antiemetic measures, and no nausea) and complete control (CC; no emetic events, no antiemetic measures, and less than mild nausea) were achieved in 51 and 61% of patients, respectively. Logistic regression analysis revealed history of motion sickness, history of pregnancy-associated vomiting and CBDCA-based chemotherapy as risk factors for CR and history of motion sickness and history of pregnancy-associated vomiting as risk factors for TC. Additional, Ages ≥65 years is an independent predictive factor for achieving TC. Conclusions Our data showed that two antiemetics were insufficient to control CINV in patients receiving CBDCA- or oxaliplatin-based chemotherapy. However, two antiemetics may be sufficiently effective for elderly male patients receiving CBDCA (AUC5) + ETP, CBDCA+PTX for lung cancer, or CAPOX. Additionally, we consider that three antiemetics are necessary for women with colorectal cancer receiving CAPOX. Risk factor analysis related to CR showed that CINV prophylaxis in patients treated with CBDCA-based chemotherapy was generally supportive of the guideline-recommended three antiemetics. However, the control of nausea in patients receiving non-CBDCA-based chemotherapy is a key point to note. The further individualization of antiemetic regimens for patients receiving MEC based on both types of chemotherapy regimens and sex is needed.
Databáze: OpenAIRE
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