Insight in the prediction of chemotherapy-induced nausea

Abstract

Purpose To identify risk factors for chemotherapy-related nausea. Methods We examined risk factors for nausea in 1696 patients from three multicenter studies conducted from 1998 to 2004. All patients were beginning a chemotherapy regimen containing cisplatin, carboplatin, or doxorubicin. Nausea was assessed on a 1 – 7 scale four times a day for four days by diary Results 1) Average nausea for breast cancer patients receiving doxorubicin (mean = 2.31) was significantly greater than for other patients receiving doxorubicin (mean 1.82), patients receiving cisplatin (mean 1.88) and patients receiving carboplatin (mean 1.45), Ps<0.01. 2) Mean nausea decreased steadily with age, P<0.0001. 3) Patients rating themselves more susceptible to nausea had significantly more nausea (adjusted mean = 2.51) than patients rating themselves less susceptible (adjusted mean = 1.92) and were 2.8 times more likely to experience severe nausea, Ps<0.0001. 4) Expected nausea was a significant predictor of average nausea, P=0.034, but not severe nausea, P=0.31. 5) No evidence that gender is a significant predictor of nausea in 299 patients with gender neutral cancers, P=0.35. Conclusions Specific patient characteristics, especially younger age and perceived susceptibility to nausea, can help clinicians in the early identification of patients who are more susceptible to treatment-related nausea.

NCCN Guidelines Insights: Antiemesis, Version 2.2017

“…9,11,12 Although vomiting can often be prevented or substantially decreased by using prophylactic antiemetic regimens, nausea is much harder to control. [13][14][15][16][17][18] The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Antiemesis are intended to provide an overview of the treatment principles for preventing chemotherapy-induced (or RT-induced) N/V, and to provide recommendations for antiemetic prophylaxis according to the emetogenic potential of antitumor therapies. These NCCN Guidelines are updated at least once a year by a multidisciplinary panel of experts; the first guidelines were published in 1997.…”

Antiemetic research: future directions

“…The most obvious of these is nausea which is not as well controlled as vomiting [30]. Nausea is an entity which encompasses different subjective and objective experiences and needs to be better defined in order to address it properly in future studies [40].…”

Prevention of Delayed Nausea: A University of Rochester Cancer Center Community Clinical Oncology Program Study of Patients Receiving Chemotherapy

“…2,3,[13][14][15] Patients with breast cancer receiving doxorubicin are especially vulnerable to nausea, and our prior research shows they are more likely to experience DN than patients receiving either cisplatin or carboplatin. 16 The National Cancer Institute-supported University of Rochester Cancer Center (URCC) Community Clinical Oncology Program (CCOP) has just completed its second study to determine optimal antiemetic therapy for control of chemotherapy-induced DN. The first study, reported earlier, given a first-generation 5-HT RA antiemetic plus dexamethasone on the day of treatment (day 1) and randomly assigned to one of the following three regimens for days 2 and 3: group 1: prochlorperazine 10 mg orally (PO) every 8 hours; group 2: any first-generation 5-HT RA using standard dosage; or group 3: prochlorperazine 10 mg PO as needed.…”