Risk factors for chemotherapy-induced nausea in pediatric patients receiving highly emetogenic chemotherapy

2018 ◽  
Vol 66 (4) ◽  
pp. e27584 ◽  
Author(s):  
L. Lee Dupuis ◽  
Roy N. Tamura ◽  
Kara M. Kelly ◽  
Jeffrey P. Krischer ◽  
Anne-Marie Langevin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pediatric Patients ◽  
Emetogenic Chemotherapy ◽  
Highly Emetogenic Chemotherapy

scholarly journals Factors Associated With Chemotherapy-Induced Vomiting Control in Pediatric Patients Receiving Moderately or Highly Emetogenic Chemotherapy: A Pooled Analysis

2020 ◽  
Vol 38 (22) ◽  
pp. 2499-2509 ◽  
Author(s):  
L. Lee Dupuis ◽  
George A. Tomlinson ◽  
Annpey Pong ◽  
Lillian Sung ◽  
Kara Bickham
Keyword(s):  
Acute Phase ◽  
Pediatric Patients ◽  
Pooled Analysis ◽  
Emetogenic Chemotherapy ◽  
Highly Emetogenic Chemotherapy ◽  
Phase Duration ◽  
Factors Associated ◽  
Antiemetic Regimen ◽  
Chemotherapy Dose ◽  
Delayed Phase

PURPOSE To identify factors associated with chemotherapy-induced vomiting (CIV) control in pediatric patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC). MATERIALS AND METHODS An individual, patient‐level, pooled analysis was performed using data from five clinical trials of aprepitant or fosaprepitant in pediatric patients receiving HEC or MEC. The proportion of individuals who experienced no vomiting (complete CIV control) during the phase of interest was the primary study end point. The association of acute-phase complete CIV control (from first chemotherapy dose to 24 hours after the last chemotherapy dose of the chemotherapy block) with age, sex, race, cancer type, acute-phase duration, and antiemetic regimen was examined. Association of the same factors and acute-phase complete CIV control with complete CIV control in the delayed phase (end of acute phase until ≤ 96 hours later) was examined. RESULTS A total of 735 patients (mean age, 8.9 years; range, 0.3 to 17.9 years) were included in the acute-phase analysis. Acute-phase complete CIV control was less likely in older patients (relative risk [RR], 0.97 per year; 95% CI, 0.96 to 0.98 per year) and longer acute-phase duration (RR, 0.89 per day; 95% CI, 0.84 to 0.94 per day). Receipt of ondansetron plus aprepitant or fosaprepitant was associated with a higher likelihood of acute-phase complete CIV control versus ondansetron alone (RR, 1.28; 95% CI, 1.09 to 1.50). Delayed-phase complete CIV control was more likely in patients with acute-phase complete CIV control (RR, 1.19; 95% CI, 1.06 to 1.34) and in those who received aprepitant or fosaprepitant. CONCLUSION Younger age, shorter acute-phase duration, and antiemetic regimen were associated with acute-phase complete CIV control in pediatric patients receiving HEC or MEC. Acute-phase complete CIV control and antiemetic regimen were associated with delayed-phase complete CIV control.

scholarly journals Efficacy, safety and feasibility of fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting in pediatric patients receiving moderately and highly emetogenic chemotherapy – results of a non-interventional observation study

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Semjon Willier ◽  
Karin Melanie Cabanillas Stanchi ◽  
Martina von Have ◽  
Vera Binder ◽  
Franziska Blaeschke ◽  
...  
Keyword(s):  
Adverse Events ◽  
Pediatric Patients ◽  
Emetogenic Chemotherapy ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Observation Study ◽  
Highly Emetogenic Chemotherapy ◽  
Antiemetic Agent ◽  
Chemotherapy Administration ◽  
Antiemetic Prophylaxis

Abstract Background Chemotherapy-induced nausea and vomiting (CINV) belong among the most burdensome side effects in hemato-oncology. Mostly, a combination of ondansetron and dexamethasone is used as antiemetic prophylaxis in pediatric patients undergoing emetogenic chemotherapy. However, dexamethasone is prohibited in different pediatric chemotherapy protocols. Currently, data on the use of ondansetron with the new antiemetic agent fosaprepitant without dexamethasone is not available for pediatric patients. Methods In this non-interventional observation study, 79 pediatric patients with a median age of 8.0 years (range 0.5–17.9 years) who received a CINV prophylaxis regimen with either fosaprepitant (4 mg/kg; maximum 150 mg) and ondansetron (as 24-h continuous infusion) (n = 40; fosaprepitant group/FG) or ondansetron only (n = 39; control group/CG) during moderately or highly emetogenic chemotherapy were analyzed. The groups were analyzed and compared for frequency of vomiting, administered doses of on-demand antiemetic dimenhydrinate and adverse events during the acute (0-24 h after chemotherapy administration) and delayed (> 24 h–120 h) CINV phases. Results A total of 112 and 116 chemotherapy blocks were analyzed in the fosaprepitant and the control group, respectively. The emetogenic potential of the administered chemotherapy did not significantly differ (p = 0.8812) between the two cohorts. In the acute CINV phase, the percentage of patients experiencing vomiting (n = 26 patients) and the vomiting events were significantly higher (p = 0.0005 and p < 0.0001, respectively) in the CG (n = 26 patients (66.7%); 88 events) compared with the FG (n = 10 patients (25.0%); 37 events). In the delayed CINV phase, the percentage of patients experiencing vomiting and the vomiting events were also significantly higher (p = 0.0017 and p < 0.0001, respectively) in the CG (n = 31 patients (79.5%); 164 events) compared with the FG (n = 17 patients (42.5%); 103 events). Additionally, significantly more dimenhydrinate doses were administered in the CG compared with the FG patients (n = 322/n = 198; p < 0.0001). The occurrence of adverse events did not significantly differ between the two groups (p > 0.05). Conclusion Fosaprepitant (4.0 mg/kg) in addition to ondansetron, without application of dexamethasone, was well tolerated, safe, effective and superior to ondansetron only as CINV prophylaxis in pediatric patients during moderately and highly emetogenic chemotherapy.

scholarly journals Pharmacotherapeutic Considerations for Use of Cannabinoids to Relieve Symptoms of Nausea and Vomiting Induced by Chemotherapy

Folia Medica ◽  
2020 ◽  
Vol 62 (4) ◽  
pp. 668-678
Author(s):  
Tijana Serafimovska ◽  
Marija Darkovska-Serafimovska ◽  
Gjoshe Stefkov ◽  
Zorica Arsova-Sarafinovska ◽  
Trajan Balkanov
Keyword(s):  
Pediatric Patients ◽  
Randomized Clinical Trials ◽  
Emetogenic Chemotherapy ◽  
Nausea And Vomiting ◽  
Web Pages ◽  
Cytotoxic Therapy ◽  
Highly Emetogenic Chemotherapy ◽  
Strict Compliance ◽  
Professional Guidelines ◽  
Better Than

Patients suffering from malignant diseases receive very often highly emetogenic chemotherapy as part of their treatment.&nbsp;With the aim of assessing the efficacy of cannabinoids in treating chemotherapy-induced nausea and vomiting (CINV), we searched the literature published until April 2020 in Medline/PubMed, Embase, the Cochrane Controlled Trials Register, and in specific web pages. Randomized clinical trials comparing cannabinoids efficacy in managing CINV with that of placebo reported absence of vomit-ing (3 trials, 168 patients) and absence of nausea and vomiting (3 trials, 288 participants). In comparison with patients receiving other antiemetics, patients receiving cannabinoids reported no nausea (5 trials, 258 participants), no vomiting (4 trials, 209 participants), and absence of both (4 trials, 414 patients). Across all trials, cannabinoids were more effective in relieving the symptoms of nausea and vomiting induced by cytotoxic therapy than placebo was and slightly better than conventional antiemetics. A retrospective review com-paring nabilone, dronabinol, delta-9-THC, and delta 8-THC with other antiemetics used to manage CINV in pediatric patients showed that these drugs could also be used as adjuvant antiemetics. Cancer patients on highly emetogenic chemotherapy but with insufficiently effective standard antiemetic therapy can be given cannabis preparations containing similar amounts of tetrahydrocannabinol and can-nabidiol, which should be received in strict compliance with the professional guidelines for the treatment of CINV.&nbsp;

Determinants of postchemotherapy nausea and vomiting in patients with cancer. Quality of Life and Symptom Control Committees of the National Cancer Institute of Canada Clinical Trials Group.

1997 ◽  
Vol 15 (1) ◽  
pp. 116-123 ◽  
Author(s):  
D Osoba ◽  
B Zee ◽  
J Pater ◽  
D Warr ◽  
J Latreille ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Factor Analysis ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Emetogenic Chemotherapy ◽  
Highly Emetogenic Chemotherapy ◽  
Final Model ◽  
To Receive

PURPOSE To assess whether prechemotherapy health-related quality-of-life (HQL) variables are associated with postchemotherapy nausea and vomiting (PCNV), and to determine their relationship to patient and treatment variables. PATIENTS AND METHODS Eight hundred thirty-two chemotherapy-naive patients scheduled to receive antiemetic regimens containing a 5-hydroxytryptamine (5-HT3) antagonist with or without dexamethasone for moderately or highly emetogenic chemotherapy were enrolled. HQL was measured by the self-report European Organization for Research and Treatment of Cancer (EORTC) Care Quality of Life Questionnaire (QLQ-C30) within 7 days before chemotherapy. Prechemotherapy HQL scores, as well as other patient, disease, and treatment variables were compared in the groups of patients who had PCNV and those who did not have PCNV. All variables were assessed initially in a univariate analysis and then together in a multivariate analysis using step-wise logistic regression. The final model generated by the multivariate analyses was used in a risk factor analysis to predict PCNV. RESULTS Univariate analyses identified 10 HQL variables and five patient and treatment characteristics that were associated with PCNV. In the multivariate analysis, the variables remaining in the final model included low social functioning, prechemotherapy nausea, female gender, highly emetogenic chemotherapy, and the lack of maintenance antiemetics (5-HT3 antagonists with or without dexamethasone) after chemotherapy. A history of low alcohol use was also associated with PCV, whereas increased fatigue and lower performance status were associated with PCN. In the risk factor analysis, the incidence of PCV increased from 20% in those having no risk factors to 76% in those having any four of the six risk factors. CONCLUSION Several pretreatment HQL, patient, and treatment characteristics are associated with the occurrence of PCNV. Patients about to receive moderately or highly emetogenic chemotherapy should be screened for these factors and additional measures, such as behavior modification and modification of antiemetic therapy, should be considered in attempts to improve the control of PCNV.

Characterizing and assessing antiemetic underuse in patients initiating highly emetogenic chemotherapy

2019 ◽  
Vol 27 (12) ◽  
pp. 4525-4534 ◽  
Author(s):  
Nirosha Mahendraratnam ◽  
Joel F. Farley ◽  
Ethan Basch ◽  
Amber Proctor ◽  
Stephanie B. Wheeler ◽  
...  
Keyword(s):  
Emetogenic Chemotherapy ◽  
Highly Emetogenic Chemotherapy
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