Evaluation of antiemetic practices for prevention of chemotherapy-induced nausea and vomiting (CINV): results of a European oncology nurse survey

Dielenseger, Pascale; Börjeson, Sussanne; Vidall, Cheryl; Young, Annie; Jahn, Patrick

doi:10.1007/s00520-019-04697-1

Cited by 31 publications

(25 citation statements)

References 16 publications

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“…However, the reported prescription patterns (Figure A) showed suboptimal adherence to guidelines, which is in line with observations in more‐recent studies . In addition, recent surveys assessing perceptions and practice patterns amongst oncology nurses in the US and Europe revealed that, from the nurses' perspective, physician preference is the main barrier to guideline‐recommended prescription of antiemetic prophylaxis …”

Section: Discussionsupporting

confidence: 85%

“…Non-adherence during home administration of antiemetics was identified as an issue in approximately one-third of patients, which supports the results of the recent surveys of oncology nurses, where patients' non-adherence to treatment was ranked amongst the top challenges in managing CINV. 12,17 Non-adherence can lead to worse outcomes of chemotherapy, as reported in patients with breast cancer receiving anthracycline-based chemotherapy. 25 While there can be multiple reasons for non-adherence to antiemetic therapy, patient characteristics, regimen complexity, and education about antiemetics are important factors.…”

Section: Potential Consequences Of Antiemetic Treatment Failurementioning

confidence: 99%

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Oncologist perspectives on chemotherapy‐induced nausea and vomiting (CINV) management and outcomes: A quantitative market research‐based survey

Aapro

Ruffo

Panteri³

et al. 2018

Cancer Reports

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Background Chemotherapy‐induced nausea and vomiting (CINV) is a distressing side effect that can negatively impact patients' quality of life and could discourage completion of chemotherapy, thereby affecting overall treatment outcomes. Although adherence to antiemetic guidelines can reduce CINV incidence in patients receiving highly or moderately emetogenic chemotherapy, CINV control remains inadequate. Aims The objectives of this survey were to determine oncologists' practice patterns in CINV management, identify factors that contribute to antiemetic treatment failure, and determine the outcomes of uncontrolled CINV on health care resource utilisation and on patients' attitude towards chemotherapy. Methods and results Quantitative market research was performed using an online questionnaire. Responses from 300 European oncologists who prescribe antiemetics and see ≥50 patients/month were analysed. Results showed that the main reasons reported by oncologists for antiemetic treatment failure were underestimating the emetogenic potential of chemotherapy, utilising weaker antiemetic regimens than required, and patient non‐adherence because of administration mistakes or missed/delayed doses. Educational initiatives for the oncology multidisciplinary team may help improve guideline‐consistent prescribing. Also, the availability of simpler, more convenient antiemetic therapies may improve guideline adherence and patient compliance during home administration. Conclusion Achieving effective CINV control is a crucial goal to improve patients' quality of life, which should optimise chemotherapy outcomes, and would ultimately reduce health care costs.

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Section: Discussionsupporting

confidence: 85%

Section: Potential Consequences Of Antiemetic Treatment Failurementioning

confidence: 99%

Oncologist perspectives on chemotherapy‐induced nausea and vomiting (CINV) management and outcomes: A quantitative market research‐based survey

Aapro

Ruffo

Panteri³

et al. 2018

Cancer Reports

View full text Add to dashboard Cite

show abstract

“…This complexity may contribute to the poor adherence seen in studies examining adherence with antiemetic guideline recommendations . Two recent published surveys of oncology nurses in the U.S. and Europe also revealed inconsistencies between antiemetic practice patterns and antiemetic guideline recommendations, with older and less effective agents often being administered. The consequences of CINV can impact both patient outcomes and cost; a recent study found CINV to be a leading factor in the 25% prevalence of avoidable acute care among patients receiving HEC .…”

Section: Introductionmentioning

confidence: 99%

Phase IIIb Safety and Efficacy of Intravenous NEPA for Prevention of Chemotherapy-Induced Nausea and Vomiting (CINV) in Patients with Breast Cancer Receiving Initial and Repeat Cycles of Anthracycline and Cyclophosphamide (AC) Chemotherapy

et al. 2019

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Background NEPA, a combination antiemetic of a neurokinin‐1 (NK1) receptor antagonist (RA) (netupitant [oral]/fosnetupitant [intravenous; IV]) and 5‐HT3RA, palonosetron] offers 5‐day CINV prevention with a single dose. Fosnetupitant solution contains no allergenic excipients, surfactant, emulsifier, or solubility enhancer. A phase III study of patients receiving cisplatin found no infusion‐site or anaphylactic reactions related to IV NEPA. However, hypersensitivity reactions and anaphylaxis have been reported with other IV NK1RAs, particularly fosaprepitant in patients receiving anthracycline‐cyclophosphamide (AC)‐based chemotherapy. This study evaluated the safety and efficacy of IV NEPA in the AC setting. Materials and Methods This phase IIIb, multinational, randomized, double‐blind study enrolled females with breast cancer naive to highly or moderately emetogenic chemotherapy. Patients were randomized to receive a single 30‐minute infusion of IV NEPA or single oral NEPA capsule on day 1 prior to AC, in repeated (up to 4) cycles. Oral dexamethasone was given to all patients on day 1 only. Results A total of 402 patients were included. The adverse event (AE) profiles were similar for IV and oral NEPA and consistent with those expected. Most AEs were mild or moderate with a similarly low incidence of treatment‐related AEs in both groups. There were no treatment‐related injection‐site AEs and no reports of hypersensitivity or anaphylaxis. The efficacy of IV and oral NEPA were similar, with high complete response (no emesis/no rescue) rates observed in cycle 1 (overall [0–120 hours] 73.0% IV NEPA, 77.3% oral NEPA) and maintained over subsequent cycles. Conclusion IV NEPA was highly effective and safe with no associated hypersensitivity and injection‐site reactions in patients receiving AC. Implications for Practice As a combination of a neurokinin‐1 (NK1) receptor antagonist (RA) and 5‐HT3RA, NEPA offers 5‐day chemotherapy‐induced nausea and vomiting prevention with a single dose and an opportunity to improve adherence to antiemetic guidelines. In this randomized multinational phase IIIb study, intravenous (IV) NEPA (fosnetupitant/palonosetron) was safe and highly effective in patients receiving multiple cycles of anthracycline‐cyclophosphamide (AC)‐based chemotherapy. Unlike other IV NK1RAs, the IV NEPA combination solution does not require any surfactant, emulsifier, or solubility enhancer and contains no allergenic excipients. Hypersensitivity reactions and anaphylaxis have been reported with other IV NK1RAs, most commonly with fosaprepitant in the AC setting. Importantly, there were no injection‐site or hypersensitivity reactions associated with IV NEPA.

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“…The implementation of antiemetic prophylaxis that is consistent with guidelines has been shown to improve CINV control [29]; however, adherence to guidelines is suboptimal in many countries [29][30][31], due to various factors, including underestimation of CINV incidence by physicians and nurses [32][33][34], lack of physician awareness, budgetary issues [35,36], and poor patient adherence [31].…”

Section: Antiemetic Guidelinesmentioning

confidence: 99%

Neurokinin-1 receptor antagonists: review of their role for the prevention of chemotherapy-induced nausea and vomiting in adults

Karthaus

Schiel

Ruhlmann

et al. 2019

Expert Review of Clinical Pharmacology

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Introduction: The addition of neurokinin-1 receptor antagonists (NK 1 RAs) to standard prophylaxis of 5-hydroxytryptamine-3 RA (5-HT 3 RA) plus dexamethasone more effectively prevents chemotherapyinduced nausea and vomiting (CINV) associated with highly and moderately emetogenic chemotherapy. Areas covered: This review presents the evidence base for the use of oral and intravenous (IV) NK 1 RAs, focusing on the pharmacologic and clinical properties as a class, and highlighting differences between agents. A PubMed literature search was conducted from 2000 to 2018. Expert opinion: Adherence to international antiemetic guidelines remains a clinical challenge. Strategies to simplify antiemetic regimens and facilitate their administration may improve compliance and treatment outcomes. The use of fixed-combination antiemetics offers clinical utility, in combining an NK 1 RA with a 5-HT 3 RA in a single oral dose. The use of long-lasting NK 1 RAs and administering CINV prophylaxis closer to the time of chemotherapy may also assist with guideline and treatment compliance, diminishing the need for home-based administration, and potentially reducing resource utilization. The availability of IV and oral formulations of NK 1 RAs and NK 1 RA-5-HT 3 RA fixed combinations offers further utility, particularly for those patients unsuited for oral administration. However, safety considerations with respect to injection site toxicity and hypersensitivity reactions of the new NK 1 RA IV formulations deserve close attention.

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Evaluation of antiemetic practices for prevention of chemotherapy-induced nausea and vomiting (CINV): results of a European oncology nurse survey

Cited by 31 publications

References 16 publications

Oncologist perspectives on chemotherapy‐induced nausea and vomiting (CINV) management and outcomes: A quantitative market research‐based survey

Oncologist perspectives on chemotherapy‐induced nausea and vomiting (CINV) management and outcomes: A quantitative market research‐based survey

Phase IIIb Safety and Efficacy of Intravenous NEPA for Prevention of Chemotherapy-Induced Nausea and Vomiting (CINV) in Patients with Breast Cancer Receiving Initial and Repeat Cycles of Anthracycline and Cyclophosphamide (AC) Chemotherapy

Neurokinin-1 receptor antagonists: review of their role for the prevention of chemotherapy-induced nausea and vomiting in adults

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