Management of Chemotherapy-Induced Nausea and Vomitting in Breast Cancer Patients: A Prospective Cohort Study

Abstract

Through a prospective cohort study we aimed to optimize prevention and management of chemotherapy-induced nausea and vomiting (CINV) in the emergence of new therapies for breast cancer patients. We included breast cancer patients treated with moderate emetogenic (MEC) or highly emetogenic chemotherapy (HEC) all stages combined, from April 2021 to November 2021. Patients were required to answer a survey of 32 questions in order to analyze the potential involvement of known and unknown risk factors in the occurrence of CINV. The acute phase of CINV was defined as nausea and vomiting that developed ≤ 24 hours after the start of chemotherapy. Delayed phase of CINV was defined as nausea and vomiting that developed > 24 hours after the start of chemotherapy. The severity of nausea and vomiting was evaluated with common terminology criteria for adverse events (CTCAE) v5.0; publish to date: November 27, 2017. Analysis and results were performed using JAMOVI statistical software. In total, 177 patients received chemotherapy, 103 patients(58%) received (HEC), and 74 patients (42%) received (MEC). All patients were female (100%). Risk factors associated to occurrence of CINV included previously known factors: Younger age than 50 years (29,8%), history of pregnancy-related nausea and vomiting (74,7%), alcohol use (no patient reported previous alcohol consumption), failure to adhere to antiemetic treatment guidelines (9,6%). The compliance with treatment score (90,4%) showed a good commitment of the patients in the process of their medical healthcare. Other potential risk factors have been also explored to determine their involvement or not in the occurrence of CINV (cancer stage, performance status, education level, chemotherapy protocols, the use of traditional herbs known as an antibacterial agent and immunity booster in our context). In the acute phase, (78%) of patients experienced nausea and (47,8%) experienced vomiting. In the delayed phase, (37,1%) of patients experienced nausea and only (15,3%) experienced vomiting. The severity of nausea and vomiting was evaluated according to CTCAE v5.0 in both groups HEC and MEC. Only (8,7%) had to stop treatment for non-tolerance (table 1-2). The present study demonstrated that high compliance to treatment guidelines for CINV and individualized care could lead to more optimal management of CINV.