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Koichi Goto
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Background Patients receiving moderate emetic risk chemotherapy (MEC) occurs chemotherapy-induced nausea and vomiting (CINV) in 30–90%, however the optimal antiemetic treatment remains controversial. Methods In this multicenter, prospective, observational study of adults treated with MEC for various cancer types in Japan, We enrolled patients kept diaries documenting CINV. All participants received a 5-HT3 receptor antagonist(5HT3RAs) and dexamethasone. We assessed various possible risk factors for complete response (CR; no emetic events and no antiemetic measures), 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) by univariate and multivariate analysis. Results Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The overall CR rate was 64%, CBDCA-based chemotherapy and oxaliplatin-based chemotherapy were particularly low. However, we showed that the CR rates in men were high in CBDCA(AUC5)＋ETP (80%), CapeOX (78%) and CBDCA+PTX for lung cancer(73% ). Emesis occurred significantly more women (30%) than men (16%) of patients overall. TC and CC were achieved by 51% and 61% of patients. Logistic regression analysis revealed that age <65 years and history of motion sickness or pregnancy-associated vomiting were risk factors for nausea and being women for vomiting. Conclusions Our data support triplet regimen including NK1 receptor antagonist with woman receiving CBDCA-based chemotherapy or oxaliplatin-based chemotherapy. However, it became clear that two antiemetics for men received CBDCA(AUC5)＋ETP, CBDCA＋PTX for lung cancer and CAPOX may be sufficiently effective. Further individualization of antiemetic regimens for patients receiving MEC on the basis of both type of chemotherapy regimen and sex is needed.
Keywords
antiemetic therapy, chemotherapy-induced nausea and vomiting (CINV), moderate emetic risk chemotherapy (MEC), NK-1 receptor antagonist, 5-HT3 receptor antagonist
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Received 07 May, 2020
Reviewer #2 agreed
On 14 Apr, 2020
Review #1 received
Received 05 Apr, 2020
Reviewers invited
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Reviewer #1 agreed
On 24 Mar, 2020
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See the published version of this preprint at BMC Pharmacology and Toxicology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Koichi Goto
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pharmacology and Toxicology.
No community comments so far
Submission checks complete
On 30 Aug, 2020
Editorial decision: Accept
On 25 Aug, 2020
No comments provided
Submission checks complete
On 15 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 12 Aug, 2020
Editor assigned
On 09 Aug, 2020
Editor invited
On 08 Aug, 2020
Submission checks complete
On 05 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 31 Jul, 2020
Review #1 received
Received 28 Jul, 2020
Reviewer #1 agreed
On 08 Jul, 2020
Reviewers invited
Invitations sent on 07 Jul, 2020
Editor assigned
On 06 Jul, 2020
Submission checks complete
On 05 Jul, 2020
Editor invited
On 05 Jul, 2020
Version 1
Posted 05 Mar, 2020
No comments provided
Editorial decision: Major revision
On 27 May, 2020
Review #2 received
Received 07 May, 2020
Reviewer #2 agreed
On 14 Apr, 2020
Review #1 received
Received 05 Apr, 2020
Reviewers invited
Invitations sent on 24 Mar, 2020
Reviewer #1 agreed
On 24 Mar, 2020
Editor invited
On 02 Mar, 2020
Editor assigned
On 17 Feb, 2020
Submission checks complete
On 16 Feb, 2020
First submitted
On 15 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pharmacology and Toxicology.
Background Patients receiving moderate emetic risk chemotherapy (MEC) occurs chemotherapy-induced nausea and vomiting (CINV) in 30–90%, however the optimal antiemetic treatment remains controversial. Methods In this multicenter, prospective, observational study of adults treated with MEC for various cancer types in Japan, We enrolled patients kept diaries documenting CINV. All participants received a 5-HT3 receptor antagonist(5HT3RAs) and dexamethasone. We assessed various possible risk factors for complete response (CR; no emetic events and no antiemetic measures), 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) by univariate and multivariate analysis. Results Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The overall CR rate was 64%, CBDCA-based chemotherapy and oxaliplatin-based chemotherapy were particularly low. However, we showed that the CR rates in men were high in CBDCA(AUC5)＋ETP (80%), CapeOX (78%) and CBDCA+PTX for lung cancer(73% ). Emesis occurred significantly more women (30%) than men (16%) of patients overall. TC and CC were achieved by 51% and 61% of patients. Logistic regression analysis revealed that age <65 years and history of motion sickness or pregnancy-associated vomiting were risk factors for nausea and being women for vomiting. Conclusions Our data support triplet regimen including NK1 receptor antagonist with woman receiving CBDCA-based chemotherapy or oxaliplatin-based chemotherapy. However, it became clear that two antiemetics for men received CBDCA(AUC5)＋ETP, CBDCA＋PTX for lung cancer and CAPOX may be sufficiently effective. Further individualization of antiemetic regimens for patients receiving MEC on the basis of both type of chemotherapy regimen and sex is needed.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
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