Prevention of chemotherapy-induced nausea and vomiting in the real-world setting in Spain

Abstract

Purpose Proper monitoring and management of chemotherapy-induced nausea and vomiting (CINV) with antiemetics is crucial for cancer patients. This study aimed to evaluate the use of antiemetics for the treatment of highly emetogenic chemotherapy (HEC) including carboplatin in the real-world setting in Spain. Methods A representative panel of cancer specialists was asked to collect information about the antiemetic treatments provided to patients receiving chemotherapy. Records formed part of the Global Oncology Monitor© database (Ipsos Healthcare, London, UK). Chemotherapy data were extrapolated using Ipsos Healthcare’s projection methodology. Results A total of 73 experts were finally included. Data from 9519 patients, estimated to be representative of 202,084 patients, were collected. HEC (and carboplatin-based chemotherapy) was administered to 73,118 (36%) patients, cisplatin-based therapy being the most frequent treatment (n = 34,649, 47.38%). Neurokinin-1 receptor antagonists (NK1RAs) alone or in combination were used as prophylaxis for CINV in 14,762 (20%) patients, while the combination of NK1RA with 5-hydroxytryptamine-3 receptor antagonist (5-HT3RAs) and dexamethasone as recommended by the international guidelines was used in 5849 (8%) patients only. No antiemetic prophylaxis was administered to 8.46% of the patients receiving HEC (n = 6189). Physicians classified cisplatin-, anthracycline-cyclophosphamide (AC-), and carboplatin-based regimens as HEC in 63%, 22% and 4% of the cases, respectively. Conclusions The use of NK1RA-containing regimens for CINV prevention in patients treated with HEC was less than expected, suggesting poor adherence to international antiemetic guidelines.

Cost-effectiveness analysis of NEPA, a fixed-dose combination of netupitant and palonosetron, for the prevention of highly emetogenic chemotherapy-induced nausea and vomiting: an international perspective

“…Poor adherence to recommended prophylaxis has been reported, in several observational studies [4][5][6]17]. Suboptimal adherence to prophylaxis may lead to uncontrolled CINV [28] with significant impact not only on patient's quality of life but also on CINV-related direct costs such as acquisition cost of antiemetic drugs and rescue medication, administration devices, add-on treatments, nursing and physician time, unscheduled office visits, emergency room admissions and, in some cases, extended hospitalization or readmission [25,35,41]; this leads to an increased economic burden to healthcare systems, as shown in various international studies.…”

Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative study

“…However, implementation of those recommendations has been reported to be inadequate worldwide 10 12–1510 and Europe 13 16. In contrast, two nationwide surveys11 17 on the use of prophylactic antiemetics for patients receiving HEC in Japan have shown that the recommended three-drug combination (serotonin-3 receptor antagonist (5HT 3 RA), dexamethasone (Dex) and neurokinin-1 receptor antagonist (NK 1 RA)) was administered in approximately 60% and 74% of patients, respectively, within 3 years of the guidelines’ publication in 2010, suggesting widespread use of appropriate antiemetic therapy.…”