Aim: This retrospective analysis evaluated chemotherapy-induced nausea and vomiting (CINV)-related hydration needs with palonosetron or granisetron extended-release subcutaneous (GERSC), approved in 2016 for CINV prevention. Materials & methods: At a community practice, CINV-related hydration per chemotherapy cycle was determined following highly (HEC) or moderately emetogenic chemotherapy (MEC) and a guideline-recommended antiemetic regimen: neurokinin 1 receptor antagonist, dexamethasone and either palonosetron only, GERSC only, or palonosetron switched to GERSC. Results: Palonosetrononly patients (n = 93) had a significantly higher mean (standard deviation) hydration rate (0.
HTX-019 is a neurokinin 1 receptor antagonist approved for prevention of acute and delayed chemotherapy-induced nausea and vomiting in patients with cancer receiving moderately and highly emetogenic chemotherapy. When administered as a 30-minute intravenous (IV) infusion, HTX-019 has displayed a tolerable and favorable safety profile in healthy subjects. This is the first study to evaluate the safety profile of multiple HTX-019 infusions in patients with cancer. This retrospective analysis shows that HTX-019 administered via IV infusion has a favorable safety profile in patients with cancer, and no new treatment-emergent adverse events were identified.
e24093 Background: Unscheduled hydrations (UHs) can significantly increase the cost of care in patients receiving moderately or highly emetogenic chemotherapy (MEC or HEC). Granisetron extended-release subcutaneous injection (GERSC) is a unique formulation of granisetron for prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV). Limited data are available regarding the impact of GERSC on cost of UHs compared to other antiemetics. Objective: Assess costs of an UHs associated with breakthrough CINV following GERSC or palonosetron (PALO) for preventing CINV in patients receiving MEC or HEC. Methods: Retrospective analysis of medical records from a single multicenter community-based practice involving patients receiving MEC or HEC with a 3-drug antiemetic regimen (neurokinin-1 receptor antagonist, dexamethasone, and either GERSC or PALO). Cost of care analysis for GERSC and PALO was based on maximum per-unit Medicare reimbursement for UHs, rescue antiemetic drugs and administration, laboratory, and office evaluations. Results: 182 patient records (n = 91 GERSC; n = 91 PALO) were evaluated. A lower number of median UHs per-patient were observed following GERSC versus PALO (HEC, 3 vs 5) and (MEC, 2 vs 3). Mean cost of care related to UHs was significantly lower per-patient following GERSC ($296, n=91) versus palonosetron ($837, n=91) ( P < 0.0001), including when the subset analysis was restricted to those patients requiring hydration (Table).When analyzing individual components of care, hydration (CPT codes 96360 and 96361) costs per-patient receiving HEC or MEC were lower following GERSC ($62, n=91) versus PALO ($253, n=91) ( P < 0.0001). Lower per-patient costs were observed following GERSC in all components of care except rescue antiemetic drug costs in MEC patients. Conclusions: GERSC reduced total per-patient costs of care associated with UHs visit relative to PALO in patients receiving HEC or MEC.[Table: see text]
108 Background: Breakthrough CT-induced nausea and vomiting (CINV) may increase resource needs, eg, hydration. GERSC (SUSTOL) + other antiemetics prevent CINV associated with MEC or anthracycline + cyclophosphamide–based therapy. This retrospective analysis evaluated CINV-related hydration in pts treated with PALO or GERSC antiemetic therapy. Methods: Pts at a multisite community practice had MEC or HEC and a 3-drug antiemetic regimen: NK-1 receptor antagonist (RA), dexamethasone, and 5-HT3 RA (PALO only, GERSC only, or PALO then GERSC). CT emetogenicity (HEC, MEC), number of cycles, and CINV-related hydration were extracted from medical records. Hydration rate (events per cycle) was analyzed for pts who had PALO vs GERSC (group 1; nonparametric 2-sided Wilcoxon rank sum test) and pts who had PALO then GERSC (group 2; paired t-test). Results: There were 93 PALO, 91 GERSC, and 48 PALO-then-GERSC pts. Group 1 had mean (SD) CT cycles of 5.4 (2.8) on PALO vs 4.1 (2.2) on GERSC. The whole group ( P<.0001) and HEC subgroup ( P<.0001) had significantly higher hydration rates with PALO vs GERSC (Table). Overall, 22% (PALO) vs 58% (GERSC) of pts had no hydration. In HEC/MEC subgroups, respectively, 19%/33% (PALO) vs 60%/56% (GERSC) of pts had no hydration. Group 2 switched pts had mean (SD) 3.5 (3.2) cycles on PALO vs 3.1 (2.2) on GERSC. All pts and MEC subgroup had no differences in hydration rate with PALO vs GERSC. HEC subgroup hydration rates were significantly higher for PALO vs GERSC ( P=.028; Table). Conclusions: In a multisite practice, CINV-related hydration was ~3 times less per CT cycle for pts receiving GERSC vs PALO as part of a 3-drug antiemetic regimen. Pts on HEC and treated with PALO then GERSC had significantly reduced hydration needs with GERSC. Reduced hydration needs may improve quality of life and simplify pt management. [Table: see text]
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