Expert Consensus on Effective Management of Chemotherapy-Induced Nausea and Vomiting: An Indian Perspective

Vaid, Ashok; Gupta, Sudeep; Doval, D.C.; Agarwal, S. S.; Nag, Shona; Patil, Poonam; Goswami, Chanchal; Ostwal, Vikas; Bhagat, Sagar; Patil, Saiprasad; Barkate, Hanmant

doi:10.3389/fonc.2020.00400

Cited by 8 publications

(8 citation statements)

References 69 publications

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“…The doses of the antiemetic used in the study were as per the standard recommendations and available studies published from India. 4 5 6 7 …”

Section: Methodsmentioning

confidence: 99%

“…The doses of the antiemetic used in the study were as per the standard recommendations and available studies published from India. [4][5][6][7] All participants receiving HEC regimen received a 5HT3 (5-hydroxytryptamine) receptor antagonist (0.25-mg palonosetron intravenously or 1-mg granisetron intravenously, with the specific agent chosen by the primary clinician) on day 1 of chemotherapy, dexamethasone (8-12 mg intravenously on day 1 and 8-mg orally on days 2, 3, and 4), an NK1 (neurokinnin 1) receptor antagonist (125-mg aprepitant orally on day 1 and 80 mg on days 2 and 3, or 150mg fosaprepitant intravenously on day 1), and olanzapine (10 mg per day orally from day 1-4) in the selected cohort.…”

Section: Treatment Regimenmentioning

confidence: 99%

“…CINV comprises of early and delayed onset, both with their own purported mechanisms. 5 Gastrointestinal (GI) cancer chemotherapy entails significant use of oxaliplatin and irinotecan in a majority of patients, thereby classifying most regimens as MEC. However, there is limited data assessing CINV in patients with GI cancers.…”

Section: Introductionmentioning

confidence: 99%

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Chemotherapy-Induced Nausea and Vomiting in Gastrointestinal Cancer Patients: Do We Need to Revisit Guidelines?

Kapoor

Jain

Sharma

et al. 2020

South Asian J Cancer

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Purpose The objective of this study was to assess the proportion of patients developing chemotherapy-induced nausea and vomiting (CINV) after receiving chemotherapy for gastrointestinal (GI) cancers, despite receiving antiemetic prophylaxis (AEP) as per the standard guidelines. Patients and Methods Between April 2019 and March 2020, all patients planned for chemotherapy were eligible for enrolment in the study. The primary endpoint of the study was the assessment of complete response (CR) rates. Results Overall, 1,276 consecutive patients were screened for this study, while 738 patients fulfilling the eligibility criteria were included. A total of 23.2% of the whole cohort failed to achieve CR. Also, 28.2, 16.9, and 16.6% of patients receiving moderately emetogenic chemotherapy (MEC), low emetogenic chemotherapy (LEC), and high emetogenic chemotherapy (HEC), respectively, failed to achieve CR. The differences in failure to achieve CR was statistically significant between MEC and HEC (p < 0.001) groups. Among MEC group, there was no difference between those who received oxaliplatin (27.8%) versus nonoxaliplatin regimens (25.8%) in terms of failure rates (p = 0.613). Conclusion Approximately one-fourth of patients failed to achieve a complete response from CINV in GI cancers despite using guideline-based AEP. Patients receiving MEC had the highest failure rates suggesting a need to improve AEP in these patients.

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“…The doses of the antiemetic used in the study were as per the standard recommendations and available studies published from India. 4 5 6 7 …”

Section: Methodsmentioning

confidence: 99%

Section: Treatment Regimenmentioning

confidence: 99%

See 1 more Smart Citation

Chemotherapy-Induced Nausea and Vomiting in Gastrointestinal Cancer Patients: Do We Need to Revisit Guidelines?

Kapoor

Jain

Sharma

et al. 2020

South Asian J Cancer

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“…Chemotherapy-induced nausea and vomiting (CINV) is one of the most frequent and anxiety-producing side effects in patients receiving chemotherapy [ 1 ]. Poorly controlled CINV may adversely affect patients' quality of life and ability to perform basic activities of daily living.…”

Section: Introductionmentioning

confidence: 99%

Effect of Acupuncture on Delayed Emesis for the Patients Who Received High-Emetogenic Chemotherapy with Standard Antiemetic Prophylaxis (KHMC-HO-01): An Open-Label, Randomized Study

Maeng

Lee

Han

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Chemotherapy-induced nausea and vomiting (CINV) is one of the most important issues associated with chemotherapy. The additional or synergistic effect of acupuncture on CINV remains controversial. Methods. Patients were randomized into either the group that received standard antiemetics with acupuncture (Arm A) or standard antiemetics only (Arm C). Acupuncture with manual stimulation was applied at eight predefined points and was started before the first cycle of chemotherapy on the first day and two additional sessions were administered on the second day of chemotherapy. Acute and delayed CINV was assessed using the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) and the MASCC Antiemesis Tool (MAT). The primary outcome was the delayed nausea score assessed using the RINVR. Results. Overall, 42 patients were included. In the delay phase, the severity of delayed nausea was slightly lower without significance in Arm A than in Arm C (5.35 vs. 5.98, p = 0.3011). Similarly, patients in Arm A reported less severe vomiting than those in Arm C (0.75 vs. 1.25, p = 0.3064). Delayed nausea and vomiting assessed by the MAT showed significant relief with acupuncture compared to standard antiemesis alone. In terms of acute emesis, there was no significant difference between the two arms according to either scoring method. Conclusions. Delayed nausea after HEC tended to decrease with acupuncture using the RINVR score, though it was also not significant. With the MAT assessment, delayed emesis (nausea and vomiting) was significantly improved with acupuncture, suggesting a promising effect of acupuncture. This trial is registered with KCT0006477.

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“…Aside from the National Comprehensive Cancer Network (NCCN), no other guidelines advocate for taking patients' risk factors into account when selecting chemotherapy and providing effective antiemetic prophylaxis [3][4][5][6]. As per Indian expert consensus on CINV, a multifaceted approach including patient risk factors ensures consistent CINV prevention [7]. Various physiological, demographic, and external factors are linked to and increase the risk of CINV in patients [1].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of an Oral Fixed-Dose Combination of Netupitant and Palonosetron (NEPA) in Patients With Multiple Risk Factors for Chemotherapy-Induced Nausea and Vomiting: A Multicenter, Observational Indian Study

Vaswani¹,

Dattatreya²,

Barkate³

et al. 2022

Cureus

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BackgroundFemale gender, young age, first chemotherapy cycle, and low alcohol intake have all been linked to an increased risk of nausea and vomiting from chemotherapy. We intended to see if netupitant and palonosetron (NEPA) could prevent chemotherapy-induced nausea and vomiting (CINV) in patients with risk factors such as age, gender, chemotherapy cycle number, and alcohol consumption history. MethodsIn this retrospective study, chemotherapy-naïve patients who were prescribed netupitant (300 mg) and palonosetron (0.50 mg) (NEPA) before the first cycle of chemotherapy were analyzed for overall, acute, and delayed phases of complete response (CR), complete protection (CP), and control. ResultsIn the acute phase (AP), delayed phase (DP), and overall phase (OP), complete response was 88.23%, 86.27%, and 86.27%, respectively; complete protection was 80.39%, 78.43%, and 76.47%, respectively; and complete control was 76.47%, 72.54%, and 70.58%, respectively, in the whole population (i.e., 51 patients). Complete response, protection, and control in the overall phase were achieved by 86.27%, 72.72%, and 68.18% of patients who received the highly emetogenic chemotherapy (HEC) regimen (i.e., 44 patients), respectively. ConclusionNEPA provided a consistent magnitude of benefit for patients who are at high risk, receiving HEC and moderately emetogenic chemotherapy (MEC), and having good control in the acute, delayed, and overall phases of CINV.

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Expert Consensus on Effective Management of Chemotherapy-Induced Nausea and Vomiting: An Indian Perspective

Cited by 8 publications

References 69 publications

Chemotherapy-Induced Nausea and Vomiting in Gastrointestinal Cancer Patients: Do We Need to Revisit Guidelines?

Chemotherapy-Induced Nausea and Vomiting in Gastrointestinal Cancer Patients: Do We Need to Revisit Guidelines?

Effect of Acupuncture on Delayed Emesis for the Patients Who Received High-Emetogenic Chemotherapy with Standard Antiemetic Prophylaxis (KHMC-HO-01): An Open-Label, Randomized Study

The Effectiveness of an Oral Fixed-Dose Combination of Netupitant and Palonosetron (NEPA) in Patients With Multiple Risk Factors for Chemotherapy-Induced Nausea and Vomiting: A Multicenter, Observational Indian Study

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