What occurs in the other 20% of cancer patients with chemotherapy-induced nausea and vomiting (CINV)? A single-institution qualitative study

Childs, Daniel S; Looker, Sherry; Le‐Rademacher, Jennifer; Ridgeway, Jennifer L.; Breitkopf, Carmen Radecki; Jatoi, Aminah

doi:10.1007/s00520-018-4323-x

Cited by 12 publications

(10 citation statements)

References 11 publications

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“…In contrast, several other studies that have described patients' and physicians' perspectives on the incidence of CINV found there to be a disparity between the reported rates. This was attributed in part to the under-reporting of CINV occurrence by patients [25,48,49] but also the overestimation of the effectiveness of antiemetic treatments by healthcare professionals both in the MEC [19,50] and HEC [19,51] settings. The results of our large study that involved inpatients and outpatients from centers of all sizes found good concurrence between physicians' and patients' opinions of the effectiveness of NEPA, which may suggest that there is a clear benefit for patients from NEPA-based antiemetic prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

Real-World Evidence of NEPA, Netupitant-Palonosetron, in Chemotherapy-Induced Nausea and Vomiting Prevention: Effects on Quality of Life

Karthaus

Oskay-Özcelik²,

Wülfing

et al. 2020

Future Oncol.

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Aim: To determine quality of life, effectiveness and safety of oral netupitant-palonosetron (NEPA)–based antiemetic prophylaxis in the real-world setting. Materials & methods: Prospective, noninterventional study in adults receiving highly or moderately emetogenic chemotherapy and NEPA for three cycles. NEPA was administered per summary of product characteristics. Results: A total of 2429 patients enrolled, 2173 were evaluable. ‘No impact on daily life’ due to vomiting was reported by 85%/82% of patients in the highly emetogenic chemotherapy/moderately emetogenic chemotherapy groups in cycle 1, with rates of 54%/59% for nausea. Overall, complete response rate was 89%/87%/75% in the acute/delayed/overall phases. NEPA was well tolerated. Conclusion: NEPA had beneficial effects on the quality of life of a heterogeneous group of cancer patients and was safe and effective in the real-world setting.

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Section: Discussionmentioning

confidence: 99%

Real-World Evidence of NEPA, Netupitant-Palonosetron, in Chemotherapy-Induced Nausea and Vomiting Prevention: Effects on Quality of Life

Karthaus

Oskay-Özcelik²,

Wülfing

et al. 2020

Future Oncol.

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“…A potential reason for the underrated CINV risk of chemotherapy by physicians is low awareness of the risk-classification described in guidelines. Additionally, patients tend to underreport CINV occurrence [40][41][42], either because they consider nausea and vomiting a sign of their chemotherapy being effective [39], fear their chemotherapy dose may be adjusted, or forget it if a long time has elapsed between its occurrence and the next medical appointment [43].…”

Section: Discussionmentioning

confidence: 99%

Practice Patterns for Prevention of Chemotherapy-Induced Nausea and Vomiting and Antiemetic Guideline Adherence Based on Real-World Prescribing Data

et al. 2021

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Background. Guideline-recommended antiemetic prophylaxis improves nausea and vomiting control in most patients undergoing chemotherapy. Multinational Association of Supportive Care in Cancer/European Society for Medical Oncology (MASCC/ESMO) antiemetic guidelines recommend prophylaxis with a neurokinin-1 receptor antagonist (NK 1 RA), a 5-hydroxytryptamine-3 (5-HT 3)RA, and dexamethasone for patients receiving highly emetogenic chemotherapy (HEC), including anthracycline-cyclophosphamide (AC)-and carboplatin (considered moderately emetogenic chemotherapy)-based chemotherapy. Here, we analyze the use of NK 1 RA-5-HT 3 RA-dexamethasone for antiemetic prophylaxis associated with HEC and carboplatin. Methods. The data source was the Global Oncology Monitor (Ipsos Healthcare). Geographically representative physicians from France, Germany, Italy, Spain, and UK were screened for treatment involvement and number of patients treated/month. Patients' data from Jan-Dec 2018 were collected from medical charts and extrapolated on the basis of the total number of physicians who prescribe chemotherapy. The emetic risk of chemotherapy was classified per MASCC/ESMO guidelines. Results. Data from 45,324 chemotherapy-treated patients were collected, representing a total extrapolated prevalence of 1,394,848 chemotherapy treatments included in the analysis. NK 1 RAs were used in 45%/42%/19% of patients receiving cisplatin-/AC-/carboplatin-based chemotherapy, respectively; 18%/24%/7% received the guidelinerecommended NK 1 RA-5-HT 3 RA-dexamethasone combination; no antiemetics were prescribed for 12% of the treatments. Often, physicians' perception of the emetic risk of chemotherapy did not follow MASCC/ESMO guideline classification. Conclusion. Low adherence to antiemetic guidelines was revealed in clinical practice in five European countries, with 15% of all HEC-/carboplatin-based treatments receiving guideline-recommended NK 1 RA-5-HT 3 RA-dexamethasone prophylaxis, and 12% of them receiving no antiemetics. New strategies for improving guideline adherence are urgently needed. The Oncologist 2021;9999:• • Implications for Practice: Despite recent advances in antiemetic therapy, a substantial proportion of patients experience nausea and vomiting associated with chemotherapy in daily clinical practice. Antiemetic guidelines aim at prevention of chemotherapy-induced nausea and vomiting (CINV) and guideline-consistent antiemetic therapy can effectively prevent vomiting and, to a lesser extent, nausea in most patients with cancer. This study reports low adherence to antiemetic guidelines in the highly emetogenic chemotherapy setting in daily clinical practice across five European countries. Opportunity

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“…Nevertheless, it is also important to consider the perspective of patients, who tend to underreport CINV [ 33 – 35 ], because they identify it as a sign of chemotherapy effectiveness [ 36 ], because they fear that a dose adjustment will be needed, or because they forget to report it if it happens some time before their next medical appointment [ 35 ]. Additionally, mistakes/issues in antiemetic administration by patients have also been suggested as a possible reason for low adherence to international recommendations [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Prevention of chemotherapy-induced nausea and vomiting in the real-world setting in Spain

et al. 2021

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Purpose Proper monitoring and management of chemotherapy-induced nausea and vomiting (CINV) with antiemetics is crucial for cancer patients. This study aimed to evaluate the use of antiemetics for the treatment of highly emetogenic chemotherapy (HEC) including carboplatin in the real-world setting in Spain. Methods A representative panel of cancer specialists was asked to collect information about the antiemetic treatments provided to patients receiving chemotherapy. Records formed part of the Global Oncology Monitor© database (Ipsos Healthcare, London, UK). Chemotherapy data were extrapolated using Ipsos Healthcare’s projection methodology. Results A total of 73 experts were finally included. Data from 9519 patients, estimated to be representative of 202,084 patients, were collected. HEC (and carboplatin-based chemotherapy) was administered to 73,118 (36%) patients, cisplatin-based therapy being the most frequent treatment (n = 34,649, 47.38%). Neurokinin-1 receptor antagonists (NK1RAs) alone or in combination were used as prophylaxis for CINV in 14,762 (20%) patients, while the combination of NK1RA with 5-hydroxytryptamine-3 receptor antagonist (5-HT3RAs) and dexamethasone as recommended by the international guidelines was used in 5849 (8%) patients only. No antiemetic prophylaxis was administered to 8.46% of the patients receiving HEC (n = 6189). Physicians classified cisplatin-, anthracycline-cyclophosphamide (AC-), and carboplatin-based regimens as HEC in 63%, 22% and 4% of the cases, respectively. Conclusions The use of NK1RA-containing regimens for CINV prevention in patients treated with HEC was less than expected, suggesting poor adherence to international antiemetic guidelines.

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What occurs in the other 20% of cancer patients with chemotherapy-induced nausea and vomiting (CINV)? A single-institution qualitative study

Abstract: These vivid data should motivate investigators to continue conducting clinical trials CINV and should remind healthcare providers about the importance of patient education on the availability of therapy for breakthrough symptomatology.

Cited by 12 publications

References 11 publications

Real-World Evidence of NEPA, Netupitant-Palonosetron, in Chemotherapy-Induced Nausea and Vomiting Prevention: Effects on Quality of Life

Real-World Evidence of NEPA, Netupitant-Palonosetron, in Chemotherapy-Induced Nausea and Vomiting Prevention: Effects on Quality of Life

Practice Patterns for Prevention of Chemotherapy-Induced Nausea and Vomiting and Antiemetic Guideline Adherence Based on Real-World Prescribing Data

Prevention of chemotherapy-induced nausea and vomiting in the real-world setting in Spain

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