Prognostic factors influencing cisplatin-induced emesis. Definition and validation of a predictive logistic model

Pollera, C. F.; Giannarelli, Diana

doi:10.1002/1097-0142(19890901)64:5<1117::aid-cncr2820640525>3.0.co;2-r

Cited by 92 publications

(49 citation statements)

References 16 publications

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“…There was more difficulty controlling postchemotherapy emesis in females, younger patients did not respond as well to antiemetics, and a history of prior alcohol intake of greater than 100 g/day was associated with less emesis following cisplatin chemotherapy [10,38,42,43]. The reason for these observations could still be a useful area for further research.…”

Section: Prognostic Factorsmentioning

confidence: 99%

Antiemetic research: future directions

Olver

Molassiotis

Aapro

et al. 2010

Support Care Cancer

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Purpose and methods As a part of reviewing the Multinational Association of Supportive Care in Cancer (MASCC) antiemetic guidelines in Perugia in 2009, an expert group identified directions for future antiemetic research. Results and conclusions In future trials, the prediction of nausea and vomiting may combine algorithms based on observed prognostic factors relating to the patient and the anticancer therapy, the identification of the genes that code for receptors, and pharmacogenetic studies of the metabolism of drugs. Design issues for future trials include standardising the emetic stimulus across studies and finding the minimum tolerated effective dose and schedule of an antiemetic. Also control of delayed emesis is not independent of the control of acute emesis. The full range of side effects and the impact on global quality of life scores should be part of the routine assessment of an antiemetic. With current high rates of control of acute vomiting, future trials will need to consider new primary endpoints such as nausea, a complex symptom, where improvement is needed. Economic endpoints should be incorporated to ascertain the cost benefit of antiemetic prophylaxis, taking into account the impact of nausea on work capacity. New antiemetic drugs may be targeted at different receptors, such as opioid, cannabinoid and peptide YY receptors. New research is needed into determining the extent of corticosteroid use. The emetic potential of a range of newer cytotoxics particularly when used in combinations and different scheduling, such as prolonged oral dosing of cytotoxics and use of targeted therapies, are all areas in need of research. More antiemetic studies are needed in niche areas such as in patients receiving high dose chemotherapy, radiation therapy or combined modality therapy. Further evidence of the efficacy of newer antiemetic agents is required in children.

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Section: Prognostic Factorsmentioning

confidence: 99%

Antiemetic research: future directions

Olver

Molassiotis

Aapro

et al. 2010

Support Care Cancer

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“…To a great extent, the relative risk of developing CINV can be assessed using a number of well-known predictive factors such as the intrinsic emetogenicity of the chemotherapy employed and certain patient factors such as gender, age, and history of alcohol consumption [3][4][5][6]. Female gender, younger age, and modest alcohol consumption all predict for a higher risk of CINV.…”

Section: Introductionmentioning

confidence: 99%

“…Until relatively recently, the standard of care for the prevention of CINV in patients with breast cancer receiving an AC regimen has been a type 3 5-hydroxytryptamine (5-HT 3 ) receptor antagonist and a corticosteroid immediately preceding chemotherapy, followed by an oral corticosteroid or a 5-HT 3 antagonist on the 2-3 days after chemotherapy [8]. In 2003, the first neurokinin-1 (NK 1 ) receptor antagonist, aprepitant, became available for use with highly emetogenic regimens such as those including cisplatin.…”

Section: Introductionmentioning

confidence: 99%

Aprepitant as salvage antiemetic therapy in breast cancer patients receiving doxorubicin and cyclophosphamide

Hesketh

Younger

Sanz-Altamira

et al. 2008

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In breast cancer patients receiving AC, the addition of aprepitant to a 5-HT(3) antagonist and dexamethasone during cycle 2 of treatment improved antiemetic outcome. Although the improvement in the primary endpoint of complete control during cycle 2 was not significant, all secondary endpoints such as complete response and no emesis rates were significantly better during cycle 2. The extent of antiemetic control during cycle 2 was numerically inferior to the results achieved in a phase III trial employing aprepitant with cycle 1 of AC chemotherapy, suggesting that the preferred approach is to include aprepitant with the initial cycle of AC chemotherapy.

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“…(3,4) There are other patient-related risk factors associated with the development of CINV, such as young age, female gender, poor performance status and low alcohol consumption. (5)(6)(7)(8)(9)(10)(11)(12) Definition of high-risk and low-risk patients for CINV may enable the reduction of incidence and severity of CINV through use of antiemetic regimens.…”

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confidence: 99%

Risk factors of chemotherapy‐induced nausea and vomiting: Index for personalized antiemetic prophylaxis

et al. 2013

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Chemotherapy-induced nausea and vomiting (CINV) is one of the most problematic adverse events that affects the well-being of cancer patients. Risk factors for CINV and its elimination are necessary to increase the indications for and effectiveness of chemotherapy. We enrolled 1549 chemotherapy-na€ ıve patients in two phase II trials and one phase III trial of palonosetron between 2005 and 2007. Treatment failure (any emetic episodes or any administration of rescue medication) and ⁄ or nausea, and their associations with patient factors were evaluated in acute and in delayed phases using univariate and multivariate analyses. Female gender (odds ratio, 95% confidence interval: 2.96, 2.09-4.20), age <55 years (2.56, 1.94-3.37), non-habitual alcohol intake (1.90, 1.43-2.51) and non-smoker (1.40, 1.04-1.90) were associated with treatment failure in the acute phase. In contrast, only female gender (1.88, 1.34-2.64) was associated with treatment failure in the delayed phase. The number of risk factors was significantly associated with CINV in both acute and delayed phases. Patient risk factors were significantly associated with CINV. Depending on the relationship between CINV-related risk factors and a tailored antiemetic treatment, high-risk patients defined by the listed risk factors may be candidates for future clinical trials. (Cancer Sci 2013; 104: 711-717) C hemotherapy-induced nausea and vomiting (CINV) is one of the most problematic adverse events that affects the quality of life of patients with cancer and may compromise adherence to treatment. Although the control of acute CINV has improved substantially with the advent of 5-hydroxytryptamine (5-HT 3 ) receptor antagonists, over 50% of patients still experience CINV in the delayed phase; that is, beyond the first 24 h after chemotherapy and for up to 5 days.(1,2) Palonosetron, a second-generation 5-HT 3 receptor antagonist, has greatly improved antiemetic therapy for delayed CINV. Because the most important factor influencing the severity of CINV is the emetogenic potential associated with chemotherapy, antiemetic prophylaxis has been developed based on the four levels of the emetic risk of chemotherapy identified in the most recent guidelines. (3,4) There are other patient-related risk factors associated with the development of CINV, such as young age, female gender, poor performance status and low alcohol consumption.(5-12) Definition of high-risk and low-risk patients for CINV may enable the reduction of incidence and severity of CINV through use of antiemetic regimens.Although several studies have identified acute phase risk factors, (5)(6)(7)(8)(9) only a few studies have addressed risk factors in the delayed phase. (10,11,13) Moreover, there are inconsistencies among the studies, partly because of the great diversity in antiemetic regimens on day 2 and thereafter, and because of the small number of patients included in these studies. The objectives of the present study were to confirm risk factors for CINV in acute and delayed phases in a large numbe...

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Prognostic factors influencing cisplatin-induced emesis. Definition and validation of a predictive logistic model

Cited by 92 publications

References 16 publications

Antiemetic research: future directions

Antiemetic research: future directions

Aprepitant as salvage antiemetic therapy in breast cancer patients receiving doxorubicin and cyclophosphamide

Risk factors of chemotherapy‐induced nausea and vomiting: Index for personalized antiemetic prophylaxis

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