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Inui N, Suzuki T, Tanaka K, Karayama M, Inoue Y, Mori K, Yasui H, Hozumi H, Suzuki Y, Furuhashi K, Fujisawa T, Matsuura S, Nishimoto K, Matsui T, Asada K, Hashimoto D, Fujii M, Niwa M, Uehara M, Matsuda H, Koda K, Ikeda M, Inami N, Tamiya Y, Kato M, Nakano H, Mino Y, Enomoto N, Suda T. Olanzapine Plus Triple Antiemetic Therapy for the Prevention of Carboplatin-Induced Nausea and Vomiting: A Randomized, Double-Blind, Placebo-Controlled Phase III Trial. J Clin Oncol 2024; 42:2780-2789. [PMID: 38833659 PMCID: PMC11315403 DOI: 10.1200/jco.24.00278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/13/2024] [Accepted: 04/04/2024] [Indexed: 06/06/2024] Open
Abstract
PURPOSE We evaluated the efficacy and safety of antiemetic therapy with olanzapine, a neurokinin-1 receptor antagonist (RA), a 5-hydroxytryptamine-3 (5-HT3) RA, and dexamethasone for preventing chemotherapy-induced nausea and vomiting in patients receiving carboplatin-containing chemotherapy. PATIENTS AND METHODS Chemotherapy-naïve patients scheduled to receive carboplatin (AUC ≥5) were randomly assigned to receive either olanzapine 5 mg once daily (olanzapine group) or placebo (placebo group) in combination with aprepitant, a 5-HT3 RA, and dexamethasone. The primary end point was the complete response (CR; no vomiting and no rescue therapy) rate in the overall phase (0-120 hours). Secondary end points included the proportion of patients free of nausea and safety. RESULTS In total, 355 patients (78.6% male, median age 72 years, 100% thoracic cancer), including 175 and 180 patients in the olanzapine and placebo groups, respectively, were evaluated. The overall CR rate was 86.9% in the olanzapine group versus 80.6% in the placebo group. The intergroup difference in the overall CR rate was 6.3% (95% CI, -1.3 to 13.9). The proportions of patients free of chemotherapy-induced nausea in the overall (88.6% in the olanzapine group v 75.0% in the placebo group) and delayed (89.7% v 75.6%, respectively) phases were significantly higher in the olanzapine group than in the placebo group (both P < .001). Somnolence was observed in 43 (24.6%) and 41 (22.9%) patients in the olanzapine and placebo groups, respectively, and no events were grade ≥3 in severity. CONCLUSION The addition of olanzapine was not associated with a significant increase in the overall CR rate. Regarding the prevention of nausea, adding olanzapine provided better control in patients receiving carboplatin-containing chemotherapy, which needs further exploration.
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Affiliation(s)
- Naoki Inui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takahito Suzuki
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kazuki Tanaka
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Department of Respiratory Medicine, Fujieda Municipal General Hospital, Fujieda, Japan
| | - Masato Karayama
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yusuke Inoue
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kazutaka Mori
- Department of Respiratory Medicine, Shizuoka City Shimizu Hospital, Shizuoka, Japan
| | - Hideki Yasui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hironao Hozumi
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuzo Suzuki
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kazuki Furuhashi
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shun Matsuura
- Department of Respiratory Medicine, Fujieda Municipal General Hospital, Fujieda, Japan
| | - Koji Nishimoto
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | - Takashi Matsui
- Department of Respiratory Medicine, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Kazuhiro Asada
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Dai Hashimoto
- Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Masato Fujii
- Department of Respiratory Medicine, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Mitsuru Niwa
- Department of Respiratory Medicine, Hamamatsu Medical Center, Hamamatsu, Japan
| | - Masahiro Uehara
- Department of Respiratory Medicine, Shimada General Medical Center, Shimada, Japan
| | - Hiroyuki Matsuda
- Department of Respiratory Medicine, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Keigo Koda
- Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Hamamatsu, Japan
| | - Masaki Ikeda
- Department of Respiratory Medicine, Shizuoka Saiseikai General Hospital, Shizuoka, Japan
| | - Nao Inami
- Department of Respiratory Medicine, Shizuoka City Shimizu Hospital, Shizuoka, Japan
| | - Yutaro Tamiya
- Department of Respiratory Medicine, Chutoen General Medical Center, Kakegawa, Japan
| | - Masato Kato
- Department of Respiratory Medicine, Ensyu Hospital, Hamamatsu, Japan
| | - Hideki Nakano
- Department of Respiratory Medicine, Japanese Red Cross Hamamatsu Hospital, Hamamatsu, Japan
| | - Yasuaki Mino
- Department of Hospital Pharmacy, Hamamatsu University Hospital, Hamamatsu, Japan
| | - Noriyuki Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Shen J, Zhao J, Jin G, Li H, Jiang Y, Wu Y, Gao J, Chen F, Li J, Wang W, Li Q. A prospective randomized controlled clinical trial investigating the efficacy of low-dose olanzapine in preventing nausea and vomiting associated with oxaliplatin-based and irinotecan-based chemotherapy. J Cancer Res Clin Oncol 2024; 150:283. [PMID: 38806870 PMCID: PMC11133208 DOI: 10.1007/s00432-024-05712-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/18/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE The aim of this study is to assess the clinical efficacy of a 5 mg dosage of olanzapine in preventing chemotherapy-induced nausea and vomiting (CINV) associated with moderately emetogenic chemotherapy (MEC) among female patients diagnosed with gastrointestinal tract tumors. METHODS Patients undergoing the oxaliplatin/irinotecan chemotherapy regimen were enrolled in this prospective controlled study. The olanzapine group received a 5 mg dosage of olanzapine along with palonosetron and dexamethasone, while the control group received a standard two-combination regimen consisting of dexamethasone and palonosetron. The primary endpoints included the total protection (TP) rates for the entire age group and the subgroup aged 60 years and above. Secondary endpoints encompassed the total protection rates during the acute and delayed phases within the two age brackets, as well as the total control (TC) rates and complete remission (CR) rates across all three phases (total, acute, and delayed). Additionally, the study involved the assessment of quality of life and the collection of adverse events associated with the interventions. RESULTS 1) Regarding the primary endpoint, the total phase TP rates within both the entire age group and the age group exceeding 60 years demonstrated superiority in the olanzapine group when compared to the control group (66.7% vs 37.25%, P = 0.003; 68.8% vs 44.4%, P = 0.044). 2) In terms of secondary endpoints, the olanzapine group exhibited superior acute phase TP rates in both age brackets when compared to the control group (P < 0.05). The olanzapine group also demonstrated higher delayed-phase TP rates, TC rates across all three phases, and CR rates within the two age brackets, although the differences were not statistically significant (P > 0.05). Furthermore, the quality of life in the olanzapine group surpassed that of the control group for both age brackets (P < 0.05), characterized by enhanced appetite and a higher incidence of drowsiness in the patients treated with olanzapine when compared to those in the control group (P < 0.05). CONCLUSION Olanzapine can enhance CINV induced by MEC regimen in female patients across all age groups, including the elderly, and therefore improve the quality of life for these patients. CLINICAL TRIAL REGISTRATION https://www.chictr.org.cn/index.html , identifier: ChiCTR20000368269, 25/08/2020.
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Affiliation(s)
- Jing Shen
- Ordos Clinical College, Baotou Medical College, Ordos, 017000, China
| | - Juan Zhao
- Department of Medical Oncology, Ordos Central Hospital, 23th Yijinhuoluo Western Road, Dongsheng District, Ordos, 017000, China
| | - Gaowa Jin
- Department of Medical Oncology, Ordos Central Hospital, 23th Yijinhuoluo Western Road, Dongsheng District, Ordos, 017000, China
| | - Hui Li
- Department of Medical Oncology, Ordos Central Hospital, 23th Yijinhuoluo Western Road, Dongsheng District, Ordos, 017000, China
| | - Ying Jiang
- Department of Medical Oncology, Ordos Central Hospital, 23th Yijinhuoluo Western Road, Dongsheng District, Ordos, 017000, China
| | - Yungaowa Wu
- Department of Medical Oncology, Ordos Central Hospital, 23th Yijinhuoluo Western Road, Dongsheng District, Ordos, 017000, China
| | - Jiali Gao
- Department of Medical Oncology, Ordos Central Hospital, 23th Yijinhuoluo Western Road, Dongsheng District, Ordos, 017000, China
| | - Feng Chen
- Department of Medical Oncology, Ordos Central Hospital, 23th Yijinhuoluo Western Road, Dongsheng District, Ordos, 017000, China
| | - Jiaxuan Li
- Ordos Clinical College, Inner Mongolia Medical University, Ordos, 017000, China
| | - Wenjuan Wang
- Department of Medical Oncology, Ordos Central Hospital, 23th Yijinhuoluo Western Road, Dongsheng District, Ordos, 017000, China.
| | - Quanfu Li
- Department of Medical Oncology, Ordos Central Hospital, 23th Yijinhuoluo Western Road, Dongsheng District, Ordos, 017000, China.
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Si X, Zhang H, Ding Q, Liu G, Huang L, Sun X. Retrospective analysis of real-world prescribing data for managing cisplatin-based chemotherapy-induced nausea and vomiting in China. Cancer Med 2024; 13:e7121. [PMID: 38515309 PMCID: PMC10958123 DOI: 10.1002/cam4.7121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/22/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The current utilization of neurokinin-1 receptor antagonists (NK1RAs) and the impact of updated guidelines on prescription patterns of antiemetic drugs among Chinese patients receiving highly emetogenic chemotherapy (HEC) remain undetermined. This study aims to analyze the present situation of Chinese cancer patients using antiemetic drugs and assess the appropriateness of antiemetic regimens. METHODS Prescription data were collected between January 2015 and December 2020 from cancer patients receiving cisplatin-based chemotherapy at 76 hospitals in six major cities in China. Trends in the use of antiemetic drugs, prescribing patterns and adherence to antiemetic guidelines were assessed. RESULTS Among the 108,611 patients included in this study, 6 classes and 17 antiemetic drugs were identified as monotherapy or combination therapy in 93,872 patients (86.4%), whereas 14,739 patients (13.6%) were administered no antiemetic treatment. 5-hydroxytryptamine 3 receptor antagonists (5-HT3RAs) and glucocorticoids were the two most frequently used classes of antiemetics, followed by metoclopramide. NK1RAs were underused across the six cities, only 9332 (8.6%) and 1655 (1.5%) cisplatin-based treatments were prescribed aprepitant and fosaprepitant, respectively. Prescriptions of olanzapine and lorazepam were very low throughout the study period. In prescribing patterns of antiemetic drugs, dual combination regimens were the most common (40.0%), followed by triple combination therapy and monotherapy (25.8% and 15.1%, respectively). Overall, the adherence to antiemetic guidelines for patients undergoing cisplatin-based regimens was only 8.1% due to inadequate prescription of antiemetic drugs. Finally, our study also revealed that 5-HT3RAs and glucocorticoids were overprescribed in 8.8% and 1.6% of patients, respectively. CONCLUSIONS The current study reveals suboptimal utilization of recommended antiemetic drugs for managing cisplatin-based HEC-induced nausea and vomiting in China. Improving the management of CINV is crucial, and these findings provide valuable insights into optimizing antiemetic drug practices.
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Affiliation(s)
- Xia Si
- Department of PharmacyPeking University People's HospitalBeijingChina
| | - Hongyan Zhang
- Orthopedic OncologyPeking University People's HospitalBeijingChina
| | - Qingming Ding
- Department of PharmacyPeking University People's HospitalBeijingChina
| | - Gang Liu
- Department of PharmacyPeking University People's HospitalBeijingChina
| | - Lin Huang
- Department of PharmacyPeking University People's HospitalBeijingChina
| | - Xin Sun
- Orthopedic OncologyPeking University People's HospitalBeijingChina
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Tsuji D, Nakagaki S, Yonezawa I, Suzuki K, Yokokawa T, Kawasaki Y, Yamaguchi T, Kawaguchi T, Hatori M, Matsumoto T, Sakata Y, Yamamoto K, Nishimura T, Kogure Y, Hayashi T, Osawa M, Itoh K, Watanabe M. A multicenter phase II trial of the triplet antiemetic therapy with palonosetron, aprepitant, and olanzapine for a cisplatin-containing regimen. - PATROL-I. Invest New Drugs 2024; 42:44-52. [PMID: 38055127 DOI: 10.1007/s10637-023-01414-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/22/2023] [Indexed: 12/07/2023]
Abstract
Dexamethasone is one of the key antiemetic agents and is widely used even now. However, dexamethasone has been associated with several adverse reactions even after short-term administration. Therefore, developing a steroid-free antiemetic regimen is an important issue to consider. Thus, the purpose of this study was to investigate the efficacy and safety of palonosetron, aprepitant, and olanzapine in a multi-institutional phase II study. Chemotherapy-naive patients scheduled to receive cisplatin were enrolled and evaluated for the occurrence of chemotherapy-induced nausea and vomiting during 120 h after chemotherapy. The primary endpoint of the study was total control (TC) in the overall phase. The key secondary endpoint was complete response (CR), which was assessed in the acute, delayed, and overall phase, respectively. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Events. Eighty-five patients were enrolled from 8 centers in Japan, of which 83 were evaluable for analyses. The percentage of patients who achieved TC during the overall phase was 31.3%. CR was achieved in 61.4%, 84.3%, and 65.1% of patients during the overall, acute, and delayed phases, respectively. The most frequently reported adverse event was anorexia. The primary endpoint was below the threshold and we could not find benefit in the dexamethasone-free regimen, but CR during the overall phase was similar to that of the conventional three-drug regimen. This antiemetic regimen without dexamethasone might be an option for patients for whom corticosteroids should not be an active application.
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Affiliation(s)
- Daiki Tsuji
- Department of Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Suruga-ku, Shizuoka, Japan.
| | - Shigeru Nakagaki
- Department of Pharmacy, Shizuoka General Hospital, Shizuoka, Japan
| | - Itsuki Yonezawa
- Department of Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Suruga-ku, Shizuoka, Japan
| | - Kenichi Suzuki
- Department of Clinical Pharmacology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Takashi Yokokawa
- Department of Pharmacy, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yohei Kawasaki
- Faculty of Nursing, Japanese Red Cross College of Nursing, Tokyo, Japan
| | - Takumi Yamaguchi
- Institute for Assistance of Academic and Education, IAAE, Kanagawa, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Masahiro Hatori
- Department of Pharmacy, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takuma Matsumoto
- Pharmaceutical Department, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan
| | - Yukio Sakata
- Department of Pharmacy, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Keisuke Yamamoto
- Department of Pharmacy, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Tomoyasu Nishimura
- Department of Pharmacy, Wakayama Medical University Hospital, Wakayama, Japan
| | - Yuki Kogure
- Department of Pharmacy, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - Toshinobu Hayashi
- Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan
| | - Misa Osawa
- Department of Pharmacy, Shizuoka General Hospital, Shizuoka, Japan
| | - Kunihiko Itoh
- Department of Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Suruga-ku, Shizuoka, Japan
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
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Hsu G, Bernhardi C, Lawson J, Duong VH, Emadi A, Niyongere S, Duffy A. Olanzapine within steroid-sparing antiemetic regimen to prevent chemotherapy-induced nausea and vomiting in patients with acute leukemia receiving multi-day intensive chemotherapy. J Oncol Pharm Pract 2023:10781552231205824. [PMID: 37817569 DOI: 10.1177/10781552231205824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
INTRODUCTION Olanzapine use for chemotherapy-induced nausea and vomiting (CINV) in hematological malignancies, for multi-day chemotherapy, and with a steroid-sparing antiemetic strategy is poorly understood. This study investigated if olanzapine is associated with improved prevention of CINV when added to a steroid-sparing antiemetic regimen in patients with acute leukemia receiving intensive, moderately emetogenic, multi-day chemotherapy. METHODS This was a single-center, retrospective cohort study in patients with acute leukemia. Patients who received olanzapine for CINV prevention were compared to those who did not. All patients received a 5-HT3 antagonist. Adult patients receiving moderately emetogenic, multi-day, intensive chemotherapy for acute leukemia were included. Patients were excluded if they received steroids greater than physiological doses during the study period. The primary endpoint was the complete response of CINV (no emesis or rescue antiemetic usage). RESULTS This study included 58 patients, 12 patients received olanzapine and 46 patients were in the control group. Baseline demographics were similar. In the study population, 89.7% had acute myeloid leukemia, median age was 54 (interquartile range 42-63) years, 34.5% were female, 27.6% had prior CINV. Complete response of CINV was similar between groups, 4 (33.3%) and 15 (32.6%) patients in the olanzapine and control groups, respectively. Safety events were similar between groups. CONCLUSION Patients with acute leukemia receiving multi-day intensive chemotherapy are at high risk for CINV. The limited data in this study suggests that olanzapine use within a steroid-sparing antiemetic regimen was well tolerated and associated with similar incidence and severity of CINV compared to the control group.
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Affiliation(s)
- Grace Hsu
- Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
| | - Ciera Bernhardi
- Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
| | - Justin Lawson
- Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
| | - Vu H Duong
- Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
- School of Medicine, University of Maryland School, Baltimore, MD, USA
| | - Ashkan Emadi
- Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
- School of Medicine, University of Maryland School, Baltimore, MD, USA
| | - Sandrine Niyongere
- Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
- School of Medicine, University of Maryland School, Baltimore, MD, USA
| | - Alison Duffy
- School of Medicine, University of Maryland School, Baltimore, MD, USA
- School of Pharmacy, University of Maryland School, Baltimore, MD, USA
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Liu A, Li M, Liu Z, Xie X, Yao W, Wang J, Zhao T, Yang J. Application of comprehensive unit-based safety program model to improve chemotherapy-induced nausea and vomiting in patients with ovarian cancer: a retrospective study. J Ovarian Res 2023; 16:143. [PMID: 37468962 DOI: 10.1186/s13048-023-01230-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/07/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND To explore the effect of intervention programs constructed under the guidance of the comprehensive unit-based safety program (CUSP) model on chemotherapy-induced nausea and vomiting (CINV) in patients with ovarian cancer. METHOD According to the time of admission, 90 ovarian cancer chemotherapy patients in the first affiliated Hospital of Anhui Medical University from June 2019 to September 2020 were divided into an intervention group and a control group with 45 cases each. Both groups of patients received routine intervention, and the intervention group implemented the CUSP program on this basis. The intervention lasted 8 months. Before and after the intervention, the patients in the ward were used the Multinational Association of Supportive Care in Cancer (MASCC) Antiemesis Tool, the Functional Living Index-Emesis (FLIE), and the Hospital Anxiety and Depression Scale (HADS) for the effect evaluation. RESULTS After the intervention, the degree of nausea and vomiting frequency in the intervention group were significantly lower than that in the control group, especially the degree of nausea in the delayed phase (P < 0.05). The score of the functional living index-emesis in the intervention group was significantly higher than that in the control group (P < 0.05), and the anxiety and depression in the intervention group were significantly relieved compared to the control group (P < 0.05). CONCLUSION The intervention program guided by the CUSP model can significantly alleviate patients' nausea and vomiting, improve the quality of life, and relieve anxiety and depression. The CUSP model is suitable for clinical practice and has guiding significance for clinical work.
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Affiliation(s)
- Aihua Liu
- Department of Gynaecology, The First Affiliated Hospital of Anhui Medical University, No.120 Wan Shui Road, Shu Shan District, Hefei, Anhui Province, 230022, China.
| | - Min Li
- Department of Gynaecology, The First Affiliated Hospital of Anhui Medical University, No.120 Wan Shui Road, Shu Shan District, Hefei, Anhui Province, 230022, China
| | - Zhuo Liu
- Department of Gynaecology, The First Affiliated Hospital of Anhui Medical University, No.120 Wan Shui Road, Shu Shan District, Hefei, Anhui Province, 230022, China
| | - Xinxin Xie
- Department of nursing management, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Wen Yao
- Department of Gynaecology, The First Affiliated Hospital of Anhui Medical University, No.120 Wan Shui Road, Shu Shan District, Hefei, Anhui Province, 230022, China
| | - Jingmin Wang
- Department of Gynaecology, The First Affiliated Hospital of Anhui Medical University, No.120 Wan Shui Road, Shu Shan District, Hefei, Anhui Province, 230022, China
| | - Tingting Zhao
- Department of Gynaecology, The First Affiliated Hospital of Anhui Medical University, No.120 Wan Shui Road, Shu Shan District, Hefei, Anhui Province, 230022, China
| | - Jie Yang
- Department of Gynaecology, The First Affiliated Hospital of Anhui Medical University, No.120 Wan Shui Road, Shu Shan District, Hefei, Anhui Province, 230022, China
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Abe M, Iihara H, Aogi K. Fosnetupitant for the Prevention of Chemotherapy-Induced Nausea and Vomiting: A Short Review and Clinical Perspective. Adv Ther 2023; 40:1913-1925. [PMID: 36884027 PMCID: PMC10129973 DOI: 10.1007/s12325-023-02474-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/17/2023] [Indexed: 03/09/2023]
Abstract
Chemotherapy-induced nausea and vomiting (CINV) is often ranked by patients as one of the most distressing and feared consequences of chemotherapy. The novel neurokinin-1 (NK1) receptor antagonist fosnetupitant, a phosphorylated prodrug formulation of netupitant, was approved in Japan in 2022. Fosnetupitant is one of the standard treatments for the prevention of CINV in patients who are receiving highly (any treatment where CINV occurs in more than 90% of patients) or moderately (where CINV occurs in 30-90% of patients) emetogenic chemotherapies. The aim of this commentary is to describe the mechanism of action, tolerability, and antiemetic efficacy of single-agent fosnetupitant in the prevention of CINV, and to discuss its clinical application, in order to aid optimal use.
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Affiliation(s)
- Masakazu Abe
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | | | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
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Abstract
Among the side effects of anticancer treatment, chemotherapy-induced nausea and vomiting (CINV) is one of the most feared given its high prevalence, affecting up to 40% of patients. It can impair patient’s quality of life and provoke low adherence to cancer treatment or chemotherapy dose reductions that can comprise treatment efficacy. Suffering CINV depends on factors related to the intrinsic emetogenicity of antineoplastic drugs and on patient characteristics. CINV can appear at different times regarding the administration of antitumor treatment and the variability of risk according to the different antitumor regimens has, as a consequence, the need for a different and adapted antiemetic treatment prophylaxis to achieve the desired objective of complete protection of the patient in the acute phase, in the late phase and in the global phase of emesis. As a basis for the recommendations, the level of emetogenicity of anticancer treatment is considered and they are classified as high, moderate, low and minimal emetogenicity and these recommendations are based on the use of antiemetic drugs with a high therapeutic index: anti 5-HT, anti-NK and steroids. Despite having highly effective treatments, clinical reality shows that they are not applied enough, so evidence-based recommendations are needed to show the best options and help in decision-making. To cover all the antiemetic prophylaxis options, we have also included recommendations for oral treatments, multiday regimens and radiation-induced emesis prevention.
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Seol A, Kim SI, Song YS. Sarcopenia: Clinical implications in ovarian cancer, diagnosis, etiology, and management. SPORTS MEDICINE AND HEALTH SCIENCE 2020; 2:202-210. [PMID: 35782999 PMCID: PMC9219260 DOI: 10.1016/j.smhs.2020.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia, loss of skeletal muscle and function, is a common condition among the elderly and is known to cause adverse health outcomes and increased risk of morbidity and mortality. This progressive and generalized disorder imposes a considerable socioeconomic burden. Sarcopenia is observed commonly in cancer patients. As Asia is one of the fastest aging regions in the world, it is clear that incidences of both sarcopenia and ovarian cancer will increase together in Asian countries. Ovarian cancer patients are vulnerable to develop sarcopenia during the treatment course and progress of disease, and a considerable number of patients with ovarian cancer seems to have physical inactivity and sarcopenia already at the time of diagnosis. Therefore, management of sarcopenia should be conducted together in parallel with ovarian cancer treatment and surveillance. Thus, in this article, we will review the clinical importance of sarcopenia in the aspect of ovarian cancer. Definition of sarcopenia, diagnosis, etiology, and intervention will be also introduced.
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Affiliation(s)
- Aeran Seol
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Se Ik Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Sang Song
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
- Corresponding author. Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, Republic of Korea.
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Di Mattei VE, Carnelli L, Taranto P, Mazzetti M, Perego G, Rottoli S, Rancoita PMV, Bergamini A, Petrone M, Rabaiotti E, Candotti G, Candiani M. Chemotherapy-induced nausea in a sample of gynaecological cancer patients: assessment issues and personal risk factors evaluation. Support Care Cancer 2020; 28:5343-5351. [PMID: 32130508 DOI: 10.1007/s00520-020-05377-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/24/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Chemotherapy-induced nausea (CIN) is a relevant problem for gynaecological cancer patients. The evaluation of CIN is a key aspect in its management, along with the identification of associated risk factors. The objective of the study was to compare different measurements of nausea and to investigate personal risk factors in CIN development. METHOD Eighty-one women treated for gynaecological cancers took part. The presence of CIN was evaluated using the MASCC Antiemesis Tool (MAT) and a patient's report to clinicians at the subsequent chemotherapy cycle. Personal risk factors were assessed using the State-Trait Anxiety Inventory and a self-report questionnaire. RESULTS The study shows that the agreement between patients' assessment of CIN with MAT and what they referred to clinicians was only moderate for acute nausea (Cohen's Kappa = 0.55; p < 0.001), while good for delayed nausea (Cohen's Kappa = 0.68; p < 0.001). At multiple logistic regression analysis, younger age, anticipatory nausea, patient medium-high expectations of CIN, and parity emerged as risk factors for the development of acute nausea (p = 0.0087, 0.0080, 0.0122 and 0.0021, respectively). Patient medium-high expectations of CIN and being single resulted to be risk factors for delayed nausea (p = 0.0397 and 0.0024, respectively). CONCLUSIONS Our findings confirm that personal factors contribute to individual differences in the development of CIN; moreover, we highlight the importance of CIN evaluation by clinicians, underlining the need to use reliable instruments.
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Affiliation(s)
- Valentina E Di Mattei
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy
- Division of Clinical Neurosciences, Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Letizia Carnelli
- Division of Clinical Neurosciences, Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.
| | - Paola Taranto
- Division of Clinical Neurosciences, Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Martina Mazzetti
- Division of Clinical Neurosciences, Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gaia Perego
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Sara Rottoli
- Division of Clinical Neurosciences, Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola M V Rancoita
- University Centre of Statistics in Biomedical Sciences CUSSB, Vita-Salute San Raffaele University, Milan, Italy
| | - Alice Bergamini
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Micaela Petrone
- Division of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuela Rabaiotti
- Division of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgio Candotti
- Division of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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11
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Prospective patient-reported symptom profiles associated with pediatric acute lymphoblastic leukemia relapse. Support Care Cancer 2020; 29:2455-2464. [PMID: 32929538 DOI: 10.1007/s00520-020-05773-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/10/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE Despite improvements in frontline pediatric acute lymphoblastic leukemia (ALL) treatment, relapse remains a concern. Research in adult cancer patients suggests that patient-reported symptoms may predict survival, but the relationship between symptoms and relapse for pediatric ALL has received little attention. METHODS Pediatric patients with ALL (age 2-18 years) and/or their primary caregivers completed symptom surveys at the end of induction, start of delayed intensification (DI), start of maintenance cycle 1 (MC1), and start of maintenance cycle 2 (MC2). Symptom clusters for co-occurring fatigue, pain, sleep disruptions, and nausea were defined using latent profile analysis. Hazard ratios (HR) and 95% confidence intervals (CI) for the association between symptom clusters, individual symptoms, and subsequent relapse were calculated using multivariable Cox proportional hazards models, adjusting for clinical and demographic factors. RESULTS Eligible patients (n = 208) were followed an average of 2.6 years for the incidence of relapse (n = 22). Associations between relapse and symptoms were identified for fatigue at DI (HR = 1.83, 95%CI 1.23-2.73) and MC1 (HR = 2.14, 95%CI 1.62-2.84), pain at DI (HR = 1.80, 95%CI 1.19-2.72), nausea at the end of induction (HR = 1.19, 95%CI 1.01-1.39), and sleep disturbances at the end of induction (HR = 2.00, 95%CI 1.11-3.62), DI (HR = 1.73, 95%CI 1.01-2.96), and MC1 (HR = 2.19, 95%CI 1.10-4.35). Symptom clusters comprised of individuals with a higher average symptom burden at DI were significantly (p < 0.05) associated with relapse. CONCLUSION Patient-reported symptoms may provide prognostic information to aid in the identification of pediatric ALL patients at increased risk of relapse.
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Bovbjerg ML, Cheyney M. Current Resources for Evidence-Based Practice, July 2020. J Obstet Gynecol Neonatal Nurs 2020; 49:391-404. [PMID: 32574584 PMCID: PMC7305877 DOI: 10.1016/j.jogn.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of whether it is ethical not to offer doula care to all women, and commentaries on reviews focused on folic acid and autism spectrum disorder, and timing of influenza vaccination during pregnancy.
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Ma S, Liu C, Li B, Zhang T, Jiang L, Wang R. Sonophoresis Enhanced Transdermal Delivery of Cisplatin in the Xenografted Tumor Model of Cervical Cancer. Onco Targets Ther 2020; 13:889-902. [PMID: 32099393 PMCID: PMC6996214 DOI: 10.2147/ott.s238126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/18/2020] [Indexed: 12/26/2022] Open
Abstract
Background Transdermal drug delivery system has been researched for a long time because of its advantage in decreasing side effects such as nausea, vomiting, and gastrointestinal disturbance. Sonophoresis has been shown to be very effective in promoting the transdermal delivery of drugs. This study is on purpose to research the feasibility of sonophoresis promoting cisplatin in the treatment of cervical cancer and the optimum drug delivery mode. Methods Thirty-two female nude-mice model of cervical cancer were randomly divided into 4 groups (n=8 in each group): control group without any intervention, low, medium and high concentration groups were treated with the corresponding cisplatin concentrations of 0.2mg/mL, 0.4mg/mL and 0.8mg/mL, respectively, with concurrent sonophoresis applied on the skin of local tumor, 1 mL at a time, once a day for a total of 5 days. Therapeutic pulsed ultrasound (TPU) was 1.0 MHz, 2.0 W/cm2 and 60-min duration. Weight of mice and tumor diameters were measured every day during the intervention. The concentration of cisplatin in tumors was detected by HPLC. Meanwhile, tumor, skin, liver and kidney gross structures and ultrastructure were observed in order to evaluate the effectiveness and safety of experimental conditions. In addition, apoptosis and proliferation-related factors (MPO, Caspase-3, PCNA) were detected by immunohistochemistry, immunofluorescence and TUNEL assay. Results The weight of nude mice in each group showed an increasing trend, except for a decrease of weight in the 0.8 mg/mL group. No obvious tumor inhibition effect was observed. Cisplatin was detected in the 0.4 mg/mL group and 0.8 mg/mL group, with relative concentrations of 0.081±0.033 mg/mL and 0.111±0.021 mg/mL, respectively. Both skin and kidney inflammation were observed in the 0.8 mg/mL group. The expression of MPO, caspase-3 and TUNEL was concentration dependent, with the highest expression in the 0.8 mg/mL group, followed by the 0.4 mg/mL group, with no significant differences between the control and the 0.2 mg/mL group. PCNA was highly expressed in both the control and 0.2 mg/mL groups but decreased in the 0.4 mg/mL and 0.8 mg/mL groups. Conclusion Sonophoresis enhanced transdermal delivery of cisplatin in a xenograft tumor model of cervical cancer. Considering the occurrence of skin inflammation and renal injury caused by cisplatin, the recommended concentration to be administered is 0.4mg/mL.
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Affiliation(s)
- Shanshan Ma
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China
| | - Chang Liu
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China
| | - Bo Li
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China
| | - Tingting Zhang
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China
| | - Li Jiang
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China
| | - Rensheng Wang
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China
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