Breakthrough chemotherapy-induced nausea and vomiting: report of a nationwide survey by the CINV Study Group of Japan

Tamura, Kazuo; Aiba, Keisuke; Sendo, Toshiaki; Nakanishi, Yoichi; Kamura, Toshiharu; Baba, Hideo; Yoshida, Kazuhiro; Yamamoto, Nobuyuki; Kitagawa, Yuko; Maehara, Yoshihiko; Shimokawa, Mototsugu; Hirata, Koichi; Kitajima, Masaki

doi:10.1007/s10147-016-1069-7

Cited by 27 publications

(16 citation statements)

References 13 publications

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“… 13 – 16 However, the recommended treatment is unable to effectively control the breakthrough CINV. 28 Navari et al reported that olanzapine was significantly better than metoclopramide in controlling breakthrough CINV in patients undergoing HEC. 29 As reported, the repeated use of rescue palonosetron is useful in controlling breakthrough CINV in HEC or moderate-emetic-risk chemotherapy, even when it was already used as prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for delayed chemotherapy-induced nausea and vomiting with low-emetic-risk chemotherapy: a prospective, observational, multicenter study

Hayashi

Shimokawa²,

Matsuo

et al. 2018

CMAR

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PurposeImprovement in the control of delayed chemotherapy-induced nausea and vomiting (CINV) is needed. There is limited information on antiemetic prophylaxis for patients undergoing low-emetic-risk chemotherapy (LEC), and the optimal antiemetic treatment is not well understood. Therefore, we analyzed the risk factors for delayed CINV to aid in the development of individualized treatments.Patients and methodsThis prospective multicenter study was conducted in 13 hospitals and included patients with solid cancers undergoing LEC. A total of 222 patients were enrolled between September 2013 and November 2014. The participants completed a daily diary for 5 days after the commencement of the first cycle of LEC to describe the daily incidence of CINV (yes/no). Furthermore, the participants described the severity of nausea and the amount of food intake with the help of VAS.ResultsTwo hundred and ten patients provided their data that were analyzed using multivariate logistic regression to examine the risk factors for delayed CINV. History of CINV, Eastern Cooperative Oncology Group performance status score ≥1, acute CINV, and single-day antiemetic prophylaxis were identified as independent risk factors for delayed CINV.ConclusionThe current use of antiemetic prophylaxis according to the recommended guideline appears to effectively control delayed CINV in patients undergoing LEC. Therefore, patients with the abovementioned risk factors should be carefully observed, and their treatment should be adjusted according to their symptoms. The use of multiple-day dexamethasone may be beneficial for those patients who develop acute CINV, especially when it is accompanied by anorexia.

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Section: Discussionmentioning

confidence: 99%

Risk factors for delayed chemotherapy-induced nausea and vomiting with low-emetic-risk chemotherapy: a prospective, observational, multicenter study

Hayashi

Shimokawa²,

Matsuo

et al. 2018

CMAR

Self Cite

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“…Although 30%-50% of patients receiving highly emetogenic chemotherapy will experience refractory vomiting despite guideline-directed prophylaxis (Cohen et al, 2007;Tamura et al, 2017), the FDA-approved cannabinoids are not recommended as first-line antiemetics and appear sparsely as adjunctive therapies in clinical guidelines (Garcia and Shamliyan, 2018). This is because dronabinol and nabilone are associated with a higher rate of side effects than other antiemetics, including attention and memory impairment and dysphoria (Wesnes et al, 2010;Tafelski et al, 2016;Mathai et al, 2018;Schussel et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Antiemetic Effects of Cannabinoid Agonists in Nonhuman Primates

Wooldridge

Liu

et al. 2020

J Pharmacol Exp Ther

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Attenuating emesis elicited by both disease and medical treatments of disease remains a critical public health challenge. Although cannabinergic medications have been used in certain treatment-resistant populations, Food and Drug Administrationapproved cannabinoid antiemetics are associated with undesirable side effects, including cognitive disruption, that limit their prescription. Previous studies have shown that a metabolically stable analog of the endocannabinoid anandamide, methanandamide (mAEA), may produce lesser cognitive disruption than that associated with the primary psychoactive constituent in cannabis, D 9 -tetrahydrocannabinol (D 9 -THC), raising the possibility that endocannabinoids may offer a therapeutic advantage over currently used medications. The present studies were conducted to evaluate this possibility by comparing the antiemetic effects of D 9 -THC (0.032-0.1 mg/kg) and mAEA (3.2-10.0 mg/kg) against nicotine-and lithium chloride (LiCl)-induced emesis and prodromal hypersalivation in squirrel monkeys. Pretreatment with 0.1 mg/kg D 9 -THC blocked nicotine-induced emesis and reduced hypersalivation in all subjects and blocked LiCl-induced emesis and reduced hypersalivation in three of four subjects. Pretreatment with 10 mg/kg mAEA blocked nicotineinduced emesis in three of four subjects and LiCl-induced emesis in one of four subjects and reduced both nicotine-and LiCl-induced hypersalivation. Antiemetic effects of D 9 -THC and mAEA were reversed by rimonabant pretreatment, providing verification of cannabinoid receptor type 1 mediation. These studies systematically demonstrate for the first time the antiemetic effects of cannabinoid agonists in nonhuman primates. Importantly, although D 9 -THC produced superior antiemetic effects, the milder cognitive effects of mAEA demonstrated in previous studies suggest that it may provide a favorable treatment option under clinical circumstances in which antiemetic efficacy must be balanced against side effect liability. SIGNIFICANCE STATEMENTEmesis has significant evolutionary value as a defense mechanism against ingested toxins; however, it is also one of the most common adverse symptoms associated with both disease and medical treatments of disease. The development of improved antiemetic pharmacotherapies has been impeded by a paucity of animal models. The present studies systematically demonstrate for the first time the antiemetic effects of the phytocannabinoid D 9 -tetrahydrocannabinol and endocannabinoid analog methanandamide in nonhuman primates.

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“…However, available antiemetics lack broad efficacy against the heterogeneous conditions by which emesis is produced. Current clinical guidelines allow for combinations of 2‐3 antiemetics from different drug classes to control emesis, but a large number of patients, including 30%‐50% of patients receiving highly emetogenic chemotherapy, continue to experience symptoms despite guideline‐directed prophylactic treatment …”

Section: Introductionmentioning

confidence: 99%

“…large number of patients, including 30%-50% of patients receiving highly emetogenic chemotherapy, continue to experience symptoms despite guideline-directed prophylactic treatment. 23,24 The development of improved antiemetic therapeutics and the elucidation of the neural mechanisms underlying the emetic reflex have been hampered by a paucity of laboratory models. [25][26][27] Perhaps the most significant impediment is related to the fact that several of the most common laboratory animals, including the mouse, rat, guinea pig, and rabbit, are physically incapable of vomiting due to a complex array of neural and anatomical constraints.…”

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confidence: 99%

An assay of drug‐induced emesis in the squirrel monkey (Saimiri sciureus)

Wooldridge

Kangas

2019

J of Medical Primatology

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Background Emesis has significant evolutionary value as a defense mechanism against ingested toxins; however, it is also one of the most common adverse symptoms associated with both disease and medical treatments of disease. The development of improved antiemetic pharmacotherapies has been impeded by a shortage of animal models. Methods The present studies characterized the responses of the squirrel monkey to pharmacologically diverse emetic drugs. Subjects were administered nicotine (0.032‐0.56 mg/kg), lithium chloride (150‐250 mg/kg), arecoline (0.01‐0.32 mg/kg), or apomorphine (0.032‐0.32 mg/kg) and observed for emesis and prodromal hypersalivation. Results Nicotine rapidly produced emesis and hypersalivation. Lithium chloride produced emesis with a longer time course without dose‐dependent hypersalivation. Arecoline produced hypersalivation but not emesis. Apomorphine failed to produce emesis or hypersalivation. Conclusions The squirrel monkey is sensitive to drug‐induced emesis by a variety of pharmacological mechanisms and is well‐positioned to examine antiemetic efficacy and clinically important side effects of candidate antiemetic pharmacotherapies.

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Breakthrough chemotherapy-induced nausea and vomiting: report of a nationwide survey by the CINV Study Group of Japan

Cited by 27 publications

References 13 publications

Risk factors for delayed chemotherapy-induced nausea and vomiting with low-emetic-risk chemotherapy: a prospective, observational, multicenter study

Risk factors for delayed chemotherapy-induced nausea and vomiting with low-emetic-risk chemotherapy: a prospective, observational, multicenter study

Antiemetic Effects of Cannabinoid Agonists in Nonhuman Primates

An assay of drug‐induced emesis in the squirrel monkey (Saimiri sciureus)

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