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Belluomini L, Avancini A, Sposito M, Pontolillo L, Tregnago D, Trestini I, Insolda J, Carbognin L, Milella M, Bria E, Pilotto S. Integrating nutrition, physical exercise, psychosocial support and antiemetic drugs into CINV management: The road to success. Crit Rev Oncol Hematol 2024; 201:104444. [PMID: 39002789 DOI: 10.1016/j.critrevonc.2024.104444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/26/2024] [Accepted: 07/06/2024] [Indexed: 07/15/2024] Open
Abstract
Over the years, advancements in antiemetic drugs have improved chemotherapy-induced nausea and vomiting (CINV) control. However, despite the antiemetics therapies, in a relevant number of adult patients (∼30 %), CINV is still persistent, leading to several complications, such as electrolyte imbalances, anorexia, and treatment discontinuation. Supportive care interventions have gained credibility in cancer care, helping to improve patients' psycho-physical condition, quality of life, and managing symptoms, including CINV. Physical exercise and tailored nutritional counseling have demonstrated benefits in reducing the severity of nausea and vomiting. Psychological intervention has been postulated as a key approach in controlling anticipatory nausea/vomiting, as well as acupuncture/acupressure has been shown to decrease nausea and vomiting after chemotherapy treatments. In the current review, we aim to provide a clinical update on current prophylactic and delayed antiemetic guidelines for CINV and an overview of the non-pharmacological interventions tested for alleviating CINV in patients with cancer.
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Affiliation(s)
- Lorenzo Belluomini
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Alice Avancini
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Marco Sposito
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Letizia Pontolillo
- UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Medical Oncology, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Daniela Tregnago
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Ilaria Trestini
- Dietetic Service, Hospital Medical Direction, University and Hospital Trust (AOUI) of Verona, Italy.
| | - Jessica Insolda
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Luisa Carbognin
- UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Medical Oncology, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Michele Milella
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Emilio Bria
- UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Medical Oncology, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Sara Pilotto
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
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Suzuki-Chiba H, Konishi T, Aso S, Makito K, Matsui H, Jo T, Fushimi K, Yasunaga H. Comparison of olanzapine 2.5 mg and 5 mg in the prevention of chemotherapy-induced nausea and vomiting: a Japanese nationwide database study. Int J Clin Oncol 2024:10.1007/s10147-024-02603-2. [PMID: 39154312 DOI: 10.1007/s10147-024-02603-2] [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: 11/19/2023] [Accepted: 08/07/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Olanzapine is prescribed as prophylaxis for chemotherapy-induced nausea and vomiting at a dose of 2.5 or 5 mg in Asian countries. We compared the effectiveness of olanzapine 2.5 mg and 5 mg in preventing chemotherapy-induced nausea and vomiting among patients receiving high-emetogenic chemotherapy for lung cancer. METHODS Using a Japanese national inpatient database, we identified patients who received olanzapine doses of 2.5 or 5 mg during high-emetogenic chemotherapy for lung cancer between January 2016 and March 2021. We conducted a 1:1 propensity score-matched analysis with adjustment for various factors, including those affecting olanzapine metabolism. The outcomes were additional antiemetic drug administration (within 2-5 days after chemotherapy initiation), length of hospital stay, and total hospitalization costs. RESULTS Olanzapine 2.5 and 5.0 mg were used in 2905 and 4287 patients, respectively. The propensity score-matched analysis showed that olanzapine 2.5 mg administration was significantly associated with a higher proportion of additional antiemetic drug administration (36% vs. 31%, p < 0.001) than olanzapine 5 mg. The median length of hospital stay was 8 days in both groups. Total hospitalization cost did not differ significantly between the two doses of olanzapine (5061 vs. 5160 USD, p = 0.07). The instrumental variable analysis demonstrated compatible results. CONCLUSION Prophylactic use of olanzapine 2.5 mg during chemotherapy for lung cancer was associated with a higher rate of additional antiemetic drugs than olanzapine 5 mg.
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Affiliation(s)
- Hiroe Suzuki-Chiba
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
| | - Takaaki Konishi
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Shotaro Aso
- Department of Real World Evidence, Graduates School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kanako Makito
- Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Taisuke Jo
- Department of Respiratory Medicine, The University of Tokyo, Tokyo, Japan
- Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
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Grimison P, Mersiades A, Kirby A, Tognela A, Olver I, Morton RL, Haber P, Walsh A, Lee Y, Abdi E, Della-Fiorentina S, Aghmesheh M, Fox P, Briscoe K, Sanmugarajah J, Marx G, Kichenadasse G, Wheeler H, Chan M, Shannon J, Gedye C, Begbie S, Simes RJ, Stockler MR. Oral Cannabis Extract for Secondary Prevention of Chemotherapy-Induced Nausea and Vomiting: Final Results of a Randomized, Placebo-Controlled, Phase II/III Trial. J Clin Oncol 2024:JCO2301836. [PMID: 39151115 DOI: 10.1200/jco.23.01836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/20/2023] [Accepted: 06/12/2024] [Indexed: 08/18/2024] Open
Abstract
PURPOSE The aim of this randomized, placebo-controlled, two-stage, phase II/III trial was to determine the efficacy of an oral cannabis extract in adults with refractory nausea and/or vomiting during moderately or highly emetogenic, intravenous chemotherapy despite guideline-consistent antiemetic prophylaxis. Here, we report results of the prespecified combined analysis including the initial phase II and subsequent phase III components. PATIENTS AND METHODS Study treatment consisted of oral capsules containing either tetrahydrocannabinol 2.5 mg plus cannabidiol 2.5 mg capsules (THC:CBD) or matching placebo, taken three times a day from days -1 to 5, in addition to guideline-consistent antiemetics. The primary measure of effect was the difference in the proportions of participants with no vomiting or retching and no use of rescue medications (a complete response) during hours 0-120 after the first cycle of chemotherapy on study (cycle A). RESULTS We recruited 147 evaluable of a planned 250 participants from 2016 to 2022. Background antiemetic prophylaxis included a corticosteroid and 5-hydroxytryptamine antagonist in 97%, a neurokinin-1 antagonist in 80%, and olanzapine in 10%. THC:CBD compared with placebo improved the complete response rate from 8% to 24% (absolute difference 16%, 95% CI, 4 to 28, P = .01), with similar effects for absence of significant nausea, use of rescue medications, daily vomits, and the nausea scale on the Functional Living Index-Emesis quality-of-life questionnaire. More frequent bothersome adverse events of special interest included sedation (18% v 7%), dizziness (10% v 0%), and transient anxiety (4% v 1%). There were no serious adverse events attributed to THC:CBD. CONCLUSION THC:CBD is an effective adjunct for chemotherapy-induced nausea and vomiting despite standard antiemetic prophylaxis, but was associated with additional adverse events. Drug availability, cultural attitudes, legal status, and preferences may affect implementation. Future analyses will evaluate the cost-effectiveness of THC:CBD.
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Affiliation(s)
- Peter Grimison
- Chris O'Brien Lifehouse, Sydney, NSW, Australia
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Antony Mersiades
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
- Dept of Medical Oncology, Northern Beaches Hospital, Frenchs Forest, NSW, Australia
| | - Adrienne Kirby
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Annette Tognela
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW, Australia
| | - Ian Olver
- University of Adelaide, Adelaide, SA, Australia
| | - Rachael L Morton
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Paul Haber
- Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Anna Walsh
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Yvonne Lee
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | | | | | - Morteza Aghmesheh
- Department of Medical Oncology, Wollongong Hospital, Wollongong, NSW, Australia
| | - Peter Fox
- Dept of Medical Oncology, Orange Base Hospital, Orange, NSW, Australia
| | - Karen Briscoe
- Department of Medical Oncology, Coffs Harbour Hospital, Coffs Harbour, NSW, Australia
| | - Jasotha Sanmugarajah
- Department of Medical Oncology, Gold Coast University Hospital, Gold Coast, QLD, Australia
| | - Gavin Marx
- Department of Medical Oncology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
| | | | - Helen Wheeler
- Department of Medical Oncology, Royal North Shore Hospital, Gosford, NSW, Australia
| | - Matthew Chan
- Department of Medical Oncology, Gosford Hospital, Gosford, NSW, Australia
| | - Jenny Shannon
- Department of Medical Oncology, Nepean Hospital, Kingswood, NSW, Australia
| | - Craig Gedye
- Department of Medical Oncology, Calvary Mater Hospital, Newcastle, NSW, Australia
| | - Stephen Begbie
- Department of Medical Oncology, Port Macquarie Hospital, Port Macquarie, NSW, Australia
| | - R John Simes
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Martin R Stockler
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
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Báez-Gutiérrez N, Suárez-Casillas P, Pérez-Moreno MA, Blázquez-Goñi C, Abdelkader-Martín L. Antiemetic prophylaxis regimens in haematologic malignancies patients undergoing a hematopoietic stem cell transplantation. Which is the best standard of care? A systematic review. Eur J Haematol 2024. [PMID: 39074908 DOI: 10.1111/ejh.14282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/03/2024] [Accepted: 07/11/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION This systematic review, adhering to PRISMA guidelines, aimed to evaluate the efficacy and safety of antiemetic prophylaxis in haematological patients undergoing high-dose chemotherapy as part of their hematopoietic stem cell transplantation (HSCT) conditioning regimens. METHODS We performed a comprehensive search in PubMed, EMBASE, ClinicalTrials.gov and the Cochrane database to identify randomised controlled trials (RCTs) and systematic reviews of antiemetic prophylaxis. Studies in English, French, Italian or Spanish were included. This review is registered with PROSPERO, ID CRD42023406380. RESULTS Eight RCTs were analysed. The antiemetic regimens evaluated ranged from monotherapy with 5-Hydroxytryptamine Receptor 3 antagonists (5-HT3RAs) to complex combinations including olanzapine, neurokinin-1 receptor antagonists, 5-HT3RAs and corticosteroids. Complete response rates for triplet or quadruple regimens varied between 23.5% and 81.9%. Although no significant adverse effects were observed, minor symptoms such as diarrhoea, constipation, sedation and headaches were reported. CONCLUSION Existing evidence on HSCT antiemetic therapy highlights its benefits but fails to provide clear clinical directions. The choice between triplet and quadruplet therapies for different patient scenarios is still uncertain. Until more detailed research is available, healthcare providers must rely on the latest guidelines and their judgement to customise antiemetic care for each patient's specific needs and risks.
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Affiliation(s)
- Nerea Báez-Gutiérrez
- Department of Pharmacy, University Hospital Nuestra Señora de Valme, Seville, Spain
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Badarudin NS, Mohamed Shah N, Mohd Tahir NA, Ahmat ANMF, Ismail F, Islahudin F, Yusak S, Muhammad S, Mohd Kassim KNB. Health-Related Quality of Life And Economic Analysis of Olanzapine Versus Aprepitant in Preventing Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy in Malaysia. Value Health Reg Issues 2024; 44:101028. [PMID: 39068865 DOI: 10.1016/j.vhri.2024.101028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 05/02/2024] [Accepted: 06/20/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES Olanzapine has been shown to be effective in preventing chemotherapy-induced nausea and vomiting (CINV) after highly emetogenic chemotherapy (HEC); however, there is limited work on the impact of CINV on health-related quality of life (HRQoL) and the comparative cost-effectiveness of CINV prophylaxis in the Malaysian context. Therefore, this study was conducted to determine the HRQoL using EQ-5D-5L and the cost-effectiveness of olanzapine compared with aprepitant for CINV prophylaxis in Malaysia using data from a local study. METHODS Fifty-nine chemo-naive patients receiving either olanzapine or aprepitant were randomly recruited and completed the EQ-5D-5L before and day 5 after HEC. HRQoL utility scores were analyzed according to the Malaysian valuation set. The economic evaluation was conducted from a healthcare payer perspective with a 5-day time horizon. Quality-adjusted life days (QALD) and the rate of successfully treated patients were used to measure health effects. The incremental cost-effectiveness ratio is assessed as the mean difference between groups' costs per mean difference in health effects. A one-way sensitivity analysis was performed to assess variations that might affect outcomes. RESULTS Aprepitant and olanzapine arms' patients had comparable baseline mean HRQoL utility scores of 0.920 (SD = 0.097) and 0.930 (SD = 0.117), respectively; however, on day 5, a significant difference (P value = .006) was observed with mean score of 0.778 (SD = 0.168) for aprepitant and 0.889 (SD = 0.133) for olanzapine. The cost per successfully treated patient in the aprepitant arm was 60 times greater than in the olanzapine arm (Malaysian Ringgit [MYR] 927 vs MYR 14.83). Likewise, the cost per QALD gain in the aprepitant arm was 36 times higher than in the olanzapine arm (MYR 57.05 vs MYR 1.57). Incremental cost-effectiveness ratio of MYR -937.00 (USD -200.98) per successfully treated patient and MYR -391.84 (USD -85.43) per QALD gained for olanzapine compared with the aprepitant-based regimen. CONCLUSIONS An olanzapine-based regimen is a cost-effective therapeutic substitution in patients receiving HEC in Malaysia.
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Affiliation(s)
| | | | | | | | - Fuad Ismail
- Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Farida Islahudin
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Semerci R, Savaş EH, Dodlek N, Şimşek E. Effects of technology-based interventions on chemotherapy-induced nausea, vomiting, and quality of life in pediatric patients: A systematic review and meta-analysis. J Pediatr Nurs 2024:S0882-5963(24)00280-X. [PMID: 39060171 DOI: 10.1016/j.pedn.2024.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 07/20/2024] [Accepted: 07/21/2024] [Indexed: 07/28/2024]
Abstract
PURPOSE This study aims to synthesize and analyze the impact of technology-based interventions on chemotherapy-induced nausea, vomiting, and quality of life in pediatric patients. DESIGN AND METHODS Seven electronic databases were searched: PubMed, Web of Science, Cochrane, MEDLINE, CINAHL, Scopus, and Google Scholar. The JBI checklist assessed the studies' methodological quality. This study was performed based on the PRISMA checklist. RESULTS This review incorporated five published studies, exploratory randomized controlled trials, and non-randomized pre and post-test control group studies involving 232 pediatric oncology patients receiving chemotherapy. The meta-analysis revealed a significant impact of technology-based interventions on alleviating chemotherapy-induced nausea and vomiting (Hedge's g = -0.707, Q = 9.61, I2 = 47.97%, p < 0.001). It was found that a significant effect of technology-based interventions on the patient's quality of life was observed (Hedge's g = -0.745, Q = 5.431, I2 = 63.74%, p < 0.001). CONCLUSIONS These findings indicated that technology-based interventions have significant potential in managing chemotherapy-induced nausea and vomiting and quality of life. PRACTICE IMPLICATIONS Future research endeavors should explore this aspect further, employing a broader range of outcome measures and longer-term follow-up assessments better to understand their impact on pediatric oncology patients' well-being.
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Affiliation(s)
| | | | - Nikolina Dodlek
- Department for Oncology, University Hospital Center Osijek, Croatia
| | - Enes Şimşek
- Koç University, School of Nursing, İstanbul, Turkey.
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Renaux Torres MC, Robinson PD, Sung L, Dupuis LL. Outcomes of chemotherapy-induced nausea and vomiting guideline adherence in pediatric and adult patients: a systematic review. Support Care Cancer 2024; 32:455. [PMID: 38913170 DOI: 10.1007/s00520-024-08623-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 06/01/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE This study describes chemotherapy-induced nausea and vomiting (CINV) control rates in pediatric and adult patients who did or did not receive guideline-consistent CINV prophylaxis. METHODS We conducted a systematic literature review of studies published in 2000 or later that evaluated CINV control in patients receiving guideline-consistent vs. guideline-inconsistent CINV prophylaxis and reported at least one CINV-related patient outcome. Studies were excluded if the guideline evaluated was not publicly available or not developed by a professional organization. Over-prophylaxis was defined as antiemetic use recommended for a higher level of chemotherapy emetogenicity than a patient was receiving. RESULTS We identified 7060 citations and retrieved 141 publications for full-text evaluation. Of these, 21 publications (14 prospective and seven retrospective studies) evaluating guidelines developed by six organizations were included. The terms used to describe CINV endpoints and definition of guideline-consistent CINV prophylaxis varied among studies. Included studies either did not address over-prophylaxis in their definition of guideline-consistent CINV prophylaxis (48%; 10/21) or defined it as guideline-inconsistent (38%; 8/21) or guideline-consistent (3/21; 14%). Eleven included studies (52%; 11/21) reported a clinically meaningful improvement in at least one CINV endpoint in patients receiving guideline-consistent CINV prophylaxis. Ten reported a statistically significant improvement. CONCLUSIONS This evidence supports the use of guideline-consistent prophylaxis to optimize CINV control. Institutions caring for patients with cancer should systematically adapt CINV CPGs for local implementation and routinely evaluate CINV outcomes.
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Affiliation(s)
| | | | - Lillian Sung
- Research Institute, The Hospital for Sick Children, Toronto, Canada
- Division of Haematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
| | - L Lee Dupuis
- Research Institute, The Hospital for Sick Children, Toronto, Canada.
- Department of Pharmacy, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1 X8, Canada.
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
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Miller M, McCann L, Lewis L, Miaskowski C, Ream E, Darley A, Harris J, Kotronoulas G, V Berg G, Lubowitzki S, Armes J, Patiraki E, Furlong E, Fox P, Gaiger A, Cardone A, Orr D, Flowerday A, Katsaragakis S, Skene S, Moore M, McCrone P, De Souza N, Donnan PT, Maguire R. Patients' and Clinicians' Perceptions of the Clinical Utility of Predictive Risk Models for Chemotherapy-Related Symptom Management: Qualitative Exploration Using Focus Groups and Interviews. J Med Internet Res 2024; 26:e49309. [PMID: 38901021 PMCID: PMC11224704 DOI: 10.2196/49309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/22/2023] [Accepted: 03/06/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Interest in the application of predictive risk models (PRMs) in health care to identify people most likely to experience disease and treatment-related complications is increasing. In cancer care, these techniques are focused primarily on the prediction of survival or life-threatening toxicities (eg, febrile neutropenia). Fewer studies focus on the use of PRMs for symptoms or supportive care needs. The application of PRMs to chemotherapy-related symptoms (CRS) would enable earlier identification and initiation of prompt, personalized, and tailored interventions. While some PRMs exist for CRS, few were translated into clinical practice, and human factors associated with their use were not reported. OBJECTIVE We aim to explore patients' and clinicians' perspectives of the utility and real-world application of PRMs to improve the management of CRS. METHODS Focus groups (N=10) and interviews (N=5) were conducted with patients (N=28) and clinicians (N=26) across 5 European countries. Interactions were audio-recorded, transcribed verbatim, and analyzed thematically. RESULTS Both clinicians and patients recognized the value of having individualized risk predictions for CRS and appreciated how this type of information would facilitate the provision of tailored preventative treatments or supportive care interactions. However, cautious and skeptical attitudes toward the use of PRMs in clinical care were noted by both groups, particularly in relationship to the uncertainty regarding how the information would be generated. Visualization and presentation of PRM information in a usable and useful format for both patients and clinicians was identified as a challenge to their successful implementation in clinical care. CONCLUSIONS Findings from this study provide information on clinicians' and patients' perspectives on the clinical use of PRMs for the management of CRS. These international perspectives are important because they provide insight into the risks and benefits of using PRMs to evaluate CRS. In addition, they highlight the need to find ways to more effectively present and use this information in clinical practice. Further research that explores the best ways to incorporate this type of information while maintaining the human side of care is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT02356081; https://clinicaltrials.gov/study/NCT02356081.
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Affiliation(s)
- Morven Miller
- Computer & Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Lisa McCann
- Computer & Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Liane Lewis
- Johnson and Johnson Medical, Norderstedt, Germany
| | | | - Emma Ream
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Andrew Darley
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Jenny Harris
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Grigorios Kotronoulas
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Geir V Berg
- Department of Health Sciences, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Simone Lubowitzki
- Department of Internal Medicine 1, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Jo Armes
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Elizabeth Patiraki
- School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Eileen Furlong
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Patricia Fox
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Alexander Gaiger
- Department of Internal Medicine 1, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Stylianos Katsaragakis
- School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Simon Skene
- Surrey Clinical Trials Unit, University of Surrey, Guildford, United Kingdom
| | - Margaret Moore
- Computer & Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Paul McCrone
- Department of Health Services and Population Research, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Nicosha De Souza
- Population Health and Genomics, Medical School, University of Dundee, Dundee, United Kingdom
| | - Peter T Donnan
- Population Health and Genomics, Medical School, University of Dundee, Dundee, United Kingdom
| | - Roma Maguire
- Computer & Information Sciences, University of Strathclyde, Glasgow, United Kingdom
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Matos AN, Silvestre SCDM, Fernandes SL, Pereira AA, Pimentel RFW, Carvalho-Rassbach M, de Albuquerque LC, Iucif N. Nutrological therapy in oncology: from prevention to nutritional support during treatment. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e2024S123. [PMID: 38865543 PMCID: PMC11164267 DOI: 10.1590/1806-9282.2024s123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/31/2023] [Indexed: 06/14/2024]
Affiliation(s)
| | | | | | | | | | | | | | - Nelson Iucif
- Brazilian Association of Nutrology – Catanduva (SP), Brazil
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10
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Li Y, Wan Y, Yang X, Chen P, Gui Y, He L, Xie Y, Tian J, Duan P, Liu G, Sun Y, Zhu J. Two doses of fosaprepitant included prophylactic treatment for the three-day cisplatin-based chemotherapy induced nausea and vomiting. J Cancer Res Clin Oncol 2024; 150:290. [PMID: 38836908 PMCID: PMC11153275 DOI: 10.1007/s00432-024-05766-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/25/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE Neurokinin 1 receptor antagonists included prophylactic treatment was recommended for patients who receive one-day cisplatin chemotherapy. It is unclear whether the prolonged administration of fosaprepitant is effective for three-day cisplatin-based chemotherapy induced nausea and vomiting (CINV). We aim to explore the prophylactic antiemetic efficacy and safety of two doses of fosaprepitant included regimen in the patients receiving multiple-day cisplatin chemotherapy. METHODS This randomized, parallel-group, open-labelled study was conducted in nine hospitals between February 2021 and February 2023. Patients diagnosed as lung cancer and chemotherapy naive were screened. Eligible participants were scheduled to be treated with highly emetogenic chemotherapy regimen which including three days of cisplatin. Then they were randomly divided into the experimental group (two doses of fosaprepitant, Group 2DF) and the control group (one dose of fosaprepitant, Group C). The primary endpoints included the safety and the average none CINV days (NCDs). This study was registered on the website of chictr.org.cn, number ChiCTR2100042665. RESULTS Overall, 204 participants were randomly assigned, and 198 patients were analyzed. No statistical difference in adverse events was found between the two groups. All treatment-related adverse effects for fosaprepitant observed were of grade 1-2. The average NCDs of Group 2DF was significantly more than Group C (18.21 ± 3.40 days vs 16.14 ± 5.20 days, P = 0.001). Furthermore, the better life function score was achieved in Group 2DF according to FLIE questionnaire. CONCLUSION The administration of two-dose fosaprepitant was safe and more effective than one dose in protecting patients from CINV induced by three-day cisplatin included chemotherapy.
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Affiliation(s)
- Yanying Li
- Division of Thoracic Tumor Multimodality Treatment and Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, 610041, China
| | - Yuming Wan
- Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Department of Medical Oncology, Shangjin Nanfu Hospital, West China Hospital, Chengdu, China
| | - Xiaoyun Yang
- Panzhihua University Affiliated Hospital, Panzhihua, China
| | - Ping Chen
- Lung Cancer Ward of Chengdu 7th People's Hospital, Chengdu, China
| | - Yan Gui
- Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Lang He
- Department of Oncology, The Fifth People's Hospital of Chengdu, Chengdu, China
| | - Yingwei Xie
- Department of Oncology, The People's Hospital of Dachuan Section, Dazhou, China
| | - Jing Tian
- Department of Oncology, The People's Hospital of Leshan, Leshan, China
| | - Ping Duan
- Department of Oncology, Chengdu First People's Hospital, Chengdu, China
| | | | - Yu Sun
- Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, China.
| | - Jiang Zhu
- Division of Thoracic Tumor Multimodality Treatment and Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, 610041, China.
- Department of Medical Oncology, Shangjin Nanfu Hospital, West China Hospital, Chengdu, China.
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11
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Ying Y, Wu H, Chen X, Zhou J, Sun Y, Fang L. Electrical acupoint stimulation for the treatment of chemotherapy-induced nausea and vomiting: A systematic review and meta-analysis. Heliyon 2024; 10:e30965. [PMID: 38799757 PMCID: PMC11126857 DOI: 10.1016/j.heliyon.2024.e30965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024] Open
Abstract
Background Chemotherapy-induced nausea and vomiting (CINV) is the most common adverse effect of chemotherapy and affects the continuation of chemotherapy in cancer patients. Electrical acupoint stimulation (EAS), which includes electroacupuncture and transcutaneous electrical stimulation (TES), has been used to treat CINV. This meta-analysis aimed to evaluate the efficacy of EAS in the treatment of CINV. Methods Randomized controlled trials (RCTs) of EAS for CINV retrieved form five key databases. Two researchers independently performed article screening, data extraction and data integration. The Cochrane Collaboration's tool for assessing risk of bias was used to assesse the methodological quality according to Cochrane Handbook for Systematic Reviews of Interventions. RevMan 5.4 was used to perform analyses. Results 10 RCTs with a total of 950 participants were included. The results showed that there was no significant difference between EAS compared to sham EAS in terms of increasing the rate of complete control of CINV and decreasing the overall incidence of CINV [RR = 1.26, 95 % CI (0.96, 1.66), P = 0.95; RR = 1.16, 95 % CI (0.97, 1.40), p = 0.71]. In terms of CINV severity, EAS reduced the occurrence of moderate-to-severe CINV [RR = 0.60, 95 % CI (0.38, 0.94), P = 0.03; RR = 0.50, 95 % CI (0.33, 0.76), P = 0.001]. Conclusion EAS could improve moderate-to-severe CINV. However, EAS did not show a significant difference in reducing overall incidence and improving complete control rates compared with sham EAS. Due to limitations in the quality of the included articles, the available studies are insufficient to have sufficient evidence to confirm the efficacy of EAS for CINV. Validation with rigorously designed, large-sample, high-quality clinical trial studies may also be needed.
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Affiliation(s)
- Yi Ying
- Department of Traditional Chinese Medicine, XianJu People's Hospital, Hangzhou Medical College, 317399, Xianju, Zhejiang, China
| | - Hui Wu
- Department of Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 310014, Hangzhou, Zhejiang, China
- Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, 310014, Hangzhou, Zhejiang, China
| | - Xuyong Chen
- Department of Traditional Chinese Medicine, XianJu People's Hospital, Hangzhou Medical College, 317399, Xianju, Zhejiang, China
| | - Ji Zhou
- Department of Traditional Chinese Medicine, XianJu People's Hospital, Hangzhou Medical College, 317399, Xianju, Zhejiang, China
| | - Yang Sun
- Department of Traditional Chinese Medicine, XianJu People's Hospital, Hangzhou Medical College, 317399, Xianju, Zhejiang, China
| | - Luecheng Fang
- Department of Traditional Chinese Medicine, XianJu People's Hospital, Hangzhou Medical College, 317399, Xianju, Zhejiang, China
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12
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Bloomhardt H, Rubin M, Xue Y, Jin Z, Masino L, Seidel D, Hijiya N, Beauchemin M. Pediatric oncology provider perspectives and patient/family perceptions of chemotherapy-induced nausea and vomiting management: Experiences at an academic medical center. Pediatr Blood Cancer 2024; 71:e30883. [PMID: 38279826 DOI: 10.1002/pbc.30883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Chemotherapy-induced nausea and vomiting (CINV) is common in children undergoing cancer treatment, and significantly impacts quality of life. Clinical practice guidelines (CPGs) have been developed to guide CINV management, though many patients do not receive guideline-concordant care. Few studies have examined provider perspectives on CINV management or preferred improvement approaches, or pediatric patient perception of CINV control. METHODS A cross-sectional study of pediatric oncology providers was conducted at a large freestanding children's hospital. Providers completed an anonymous online survey about CINV control in patients admitted for scheduled chemotherapy, and their knowledge and utilization of CINV CPGs. A survey of English and Spanish-speaking pediatric oncology patients admitted for scheduled chemotherapy was conducted to assess CINV management, with key demographics used to understand association with perceptions and adherence to antiemetic guidelines. RESULTS For providers, 75% of respondents felt CINV management could be moderately or extremely improved, significantly more so by chemotherapy prescribers and pediatric medical residents than nurses. Over half of respondents did not have awareness of CINV CPGs, particularly pediatric medical residents. For patients, nausea was reported to be extremely well controlled in 44% of cases, and vomiting extremely well controlled in 50% of cases. There were no significant differences in patient-reported CINV across demographics, when considering emetogenicity of chemotherapy received, or concordance to guidelines. CONCLUSIONS Implementing education in this area may help to improve provider comfort, and ultimately, the patient experience. Future studies will expand upon this novel patient perception, and develop and evaluate CINV management interventions.
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Affiliation(s)
- Hadley Bloomhardt
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA
- Pediatric Advanced Care Team, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Melissa Rubin
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- NewYork-Presbyterian Morgan Stanley Children's Hospital, NewYork, New York, USA
| | - Yanling Xue
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Zhezhen Jin
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Laura Masino
- NewYork-Presbyterian Morgan Stanley Children's Hospital, NewYork, New York, USA
| | - Drew Seidel
- NewYork-Presbyterian Morgan Stanley Children's Hospital, NewYork, New York, USA
| | - Nobuko Hijiya
- Division of Pediatric Hematology/Oncology/Stem Cell Transplantation, Columbia University Irving Medical Center, New York, New York, USA
| | - Melissa Beauchemin
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York, USA
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13
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Gao F, Xue C, Dong J, Lu X, Yang N, Ou C, Mou X, Zhang YZ, Dong X. Tumor Microenvironment-Induced Drug Depository for Persistent Antitumor Chemotherapy and Immune Activation. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2307736. [PMID: 38009506 DOI: 10.1002/smll.202307736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/16/2023] [Indexed: 11/29/2023]
Abstract
Herein, a drug-loading nanosystem that can in situ form drug depository for persistent antitumor chemotherapy and immune regulation is designed and built. The system (DOX@MIL-LOX@AL) is fabricated by packaging alginate on the surface of Doxorubicin (DOX) and lactate oxidase (LOX) loaded MIL-101(Fe)-NH2 nanoparticle, which can easily aggregate in the tumor microenvironment through the cross-linking with intratumoral Ca2+. Benefiting from the tumor retention ability, the fast-formed drug depository will continuously release DOX and Fe ions through the ATP-triggered slow degradation, thus realizing persistent antitumor chemotherapy and immune regulation. Meanwhile, LOX in the non-aggregated nanoparticles is able to convert the lactic acid to H2O2, which will be subsequently decomposed into ·OH by Fe ions to further enhance the DOX-induced immunogenic death effect of tumor cells. Together, with the effective consumption of immunosuppressive lactic acid, long-term chemotherapy, and oxidation therapy, DOX@MIL-LOX@AL can execute high-performance antitumor chemotherapy and immune activation with only one subcutaneous administration.
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Affiliation(s)
- Fan Gao
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Nanjing, 210044, China
- Institute of Advanced Materials and Flexible Electronics (IAMFE), School of Chemistry and Materials Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Chun Xue
- Institute of Advanced Materials and Flexible Electronics (IAMFE), School of Chemistry and Materials Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Jianhui Dong
- Institute of Advanced Materials and Flexible Electronics (IAMFE), School of Chemistry and Materials Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Xinxin Lu
- Institute of Advanced Materials and Flexible Electronics (IAMFE), School of Chemistry and Materials Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Nan Yang
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Cancer Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China
| | - Changjin Ou
- Institute of Advanced Materials and Flexible Electronics (IAMFE), School of Chemistry and Materials Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Xiaozhou Mou
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Cancer Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China
| | - Yi-Zhou Zhang
- Institute of Advanced Materials and Flexible Electronics (IAMFE), School of Chemistry and Materials Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Xiaochen Dong
- Key Laboratory of Flexible Electronics (KLOFE) and Institute of Advanced Materials (IAM), Nanjing Tech University (NanjingTech), Nanjing, 211816, China
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, China
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14
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Nelwati N, Noviyani D. The effect of diaphragmatic breathing on nausea, vomiting and functional status among breast cancer patients undergoing chemotherapy. Eur J Oncol Nurs 2024; 70:102548. [PMID: 38513453 DOI: 10.1016/j.ejon.2024.102548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 02/16/2024] [Accepted: 03/03/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To examine the effect of diaphragmatic breathing (DB) on nausea, vomiting, and functional status among breast cancer patients undergoing chemotherapy in Indonesia. METHODS A quasi experimental study with non-equivalent pretest and posttest control group was conducted. A total of forty-eight breast cancer patients (24 DB and 24 control participants) undergoing chemotherapy participated in this study selected conveniently. DB intervention was performed to the intervention group after chemotherapy cycle twice a day for six days, meanwhile the control group received usual care. A set of questionnaires was used to collect data consisting of Patient Information Form, Rhodes Index Nausea, Vomiting and Retching (RINVR) and The Functional Living Index-Cancer (FLI-C). Data were analyzed and interpreted using Generalized Linear Model, Wilcoxon Test, Paired T Test and Mann-Whitney U test. RESULTS There were significant changes in RINVR mean scores for the intervention group that started on the third day after chemotherapy (p = 0.000); meanwhile, the significant changes in RINVR mean scores for the control group began on the fifth day (p = 0.000). The total score of FLI-C was significantly different between the intervention and control groups (p = 0.000). CONCLUSION DB could decrease nausea and vomiting, and increase functional status of breast cancer patients undergoing chemotherapy. It can be promoted as a useful low-cost self-management approach and an additional and complementary therapy to manage chemotherapy-related nausea and vomiting.
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Affiliation(s)
- Nelwati Nelwati
- Faculty of Nursing, Universitas Andalas, Padang, West Sumatera, Indonesia.
| | - Dwi Noviyani
- Dr. Rasidin District Hospital, Padang, West Sumatera, Indonesia
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15
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Becherini C, Salvestrini V, Desideri I, Vagnoni G, Bonaparte I, Bertini N, Mattioli C, Angelini L, Visani L, Scotti V, Livi L, Caini S, Bonomo P. Impact of fosaprepitant in the prevention of nausea and emesis in head and neck cancer patients undergoing cisplatin-based chemoradiation: a pilot prospective study and a review of literature. LA RADIOLOGIA MEDICA 2024; 129:457-466. [PMID: 38351333 PMCID: PMC10942929 DOI: 10.1007/s11547-024-01757-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/03/2024] [Indexed: 03/16/2024]
Abstract
PURPOSE Cisplatin-based chemoradiotherapy (CRT) is standard treatment for head and neck squamous cell carcinoma (HNSCC). However, IMRT may increase chemotherapy-induced nausea and vomiting (CINV). The purpose of this study is to investigate the effect of fosaprepitant in preventing CINV. METHODS An infusion of 150 mg fosaprepitant was given through a 30 min. We assessed acute toxicity using CTCAE v.4 and the incidence of CINV using the FLIE questionnaire. The evaluation of CINV was done at the second and fifth weeks of CRT and 1 week after the end. The EORTC QLQ-HN 43 questionnaire was administered before treatment beginning (baseline), at second (T1) and fifth (T2) weeks. A dosimetric analysis was performed on dorsal nucleus of vagus (DVC) and area postrema (AP). RESULTS Between March and November 2020, 24 patients were enrolled. No correlation was found between nausea and DVC mean dose (p = 0.573), and AP mean dose (p = 0.869). Based on the FLIE questionnaire, patients reported a mean score of 30.5 for nausea and 30 for vomiting during week 2 and 29.8 for nausea and 29.2 for vomiting during week 5. After treatment ended, the mean scores were 27.4 for nausea and 27.7 for vomiting. All patients completed the EORTC QLQ-HN 43. Significantly higher scores at T2 assessment than baseline were observed. CONCLUSIONS The use of fosaprepitant in preventing CINV reduced incidence of moderate to severe nausea and vomiting. No correlation has been found between nausea and median dose to DVC and AP.
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Affiliation(s)
- Carlotta Becherini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Viola Salvestrini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy.
| | - Isacco Desideri
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Giulia Vagnoni
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Ilaria Bonaparte
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Niccolò Bertini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Chiara Mattioli
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Lucia Angelini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Luca Visani
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Vieri Scotti
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Lorenzo Livi
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Pierluigi Bonomo
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
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16
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França de Moraes GH, Lima LC, Couceiro TCDM, Lins MM, Cumino DDO, Simões LABM, Mello MJGD. Vomiting after intrathecal chemotherapy under anesthesia in pediatric patients with hematologic cancers: A cohort study. Paediatr Anaesth 2024; 34:51-59. [PMID: 37727104 DOI: 10.1111/pan.14756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Despite preventive strategies, vomiting is an adverse event affecting patients with cancer. However, literature on the incidence and risk factors for vomiting in pediatric patients with cancer are scarce. AIM To assess the incidence and risk factors for vomiting within 24 h and goodness of fit for the Eberhart score in pediatric patients with hematologic cancers after receiving intrathecal chemotherapy under deep sedation. METHODS This prospective cohort study included patients under 20 years of age with hematologic cancers who were scheduled to undergo intrathecal chemotherapy under anesthesia. The primary outcome was the occurrence of vomiting within 24 h after the end of anesthesia. Sociodemographic and procedure data and underlying diseases were collected. Patients were monitored during the procedure, in the postanesthesia care unit, and the day after (by phone call). RESULTS A total of 139 patients were included, and the incidence of vomiting was 30.9% within 24 h after intrathecal chemotherapy under anesthesia, with 90.7% of vomiting prior to 6 h. Prophylactic ondansetron was administered prior to the procedure to 45.3% of patients. Risk factors for vomiting were female gender (hazard ratio: 2.47, 95% confidence interval: 1.35-4.53, p: .003), consolidation phase of treatment (hazard ratio: 2.16, 95% confidence interval: 1.10-4.24, p: .025), and history of kinetosis (hazard ratio: 2.49, 95% confidence interval: 1.31-4.70, p: .005). Incidence of vomit was higher than estimated by the Eberhart score distribution (observed incidence in patients with a score of zero: 33.3%; with a score of one: 28.8%; with a score of two: 60%). CONCLUSION A high incidence of vomiting was observed within 24 h after intrathecal chemotherapy under propofol deep sedation. Risk factors for this outcome were established (being female, consolidation phase of treatment, and previous kinetosis), and evidence suggested that the Eberhart score was not suitable for the studied population.
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Affiliation(s)
| | - Luciana Cavalcanti Lima
- Department of Pediatric Anesthesiology, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil
- Faculdade Pernambucana de Saúde, Recife, Brazil
| | | | - Mecneide Mendes Lins
- Pediatric Oncology Unit, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil
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17
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Baéz-Gutierrez N, Suárez-Casillas P, Pérez-Moreno MA, Blázquez-Goñi C, Abdelkader-Martín L. Antiemetic prophylaxis in hematologic malignancies patients receiving conditioning protocols for hematopoietic stem cell transplantation: A study protocol for a systematic review. FARMACIA HOSPITALARIA 2023; 47:T289-T293. [PMID: 37858519 DOI: 10.1016/j.farma.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE Chemotherapy-induced nausea and vomiting continue to pose a significant challenge for patients undergoing hematopoietic stem cell transplantation. This study aims to synthesize available evidence on antiemetic prophylaxis regimens in patients with hematologic malignancies undergoing hematopoietic stem cell transplantation, in order to identify the best standard of care. METHODS A systematic review will be conducted using MEDLINE via PubMed, EMBASE, ClinicalTrials.gov., and Cochrane databases. Studies written in English, French, Italian or Spanish will be considered. After screening the literature according to the inclusion and exclusion criteria, two independent reviewers will extract data and assess the risk of bias in eligible articles. This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. This protocol is registered in the Prospective Register of Ongoing Systematic Reviews (PROSPERO) CRD42023406380. DISCUSSION Chemotherapy-induced nausea and vomiting is a debilitating side effect that presents a significant challenge for patients with hematologic malignancies. Despite the publication of various guidelines, none of them includes specific recommendations for each chemotherapy regimen. Therefore, analyzing the primary antiemetic prophylaxis regimens in patients with hematologic malignancies undergoing hematopoietic stem cell transplantation would be valuable in enhancing patients' quality of life.
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18
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Baéz-Gutierrez N, Suárez-Casillas P, Pérez-Moreno MA, Blázquez-Goñi C, Abdelkader-Martín L. Antiemetic prophylaxis in hematologic malignancies patients receiving conditioning protocols for hematopoietic stem cell transplantation: A study protocol for a systematic review. FARMACIA HOSPITALARIA 2023; 47:289-293. [PMID: 37541914 DOI: 10.1016/j.farma.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/06/2023] Open
Abstract
OBJECTIVE Chemotherapy-induced nausea and vomiting continue to pose a significant challenge for patients undergoing hematopoietic stem cell transplantation. This study aims to synthesize available evidence on antiemetic prophylaxis regimens in patients with hematologic malignancies undergoing hematopoietic stem cell transplantation, in order to identify the best standard of care. METHODS A systematic review will be conducted using MEDLINE via PubMed, EMBASE, Clinical-Trials.gov., and Cochrane databases. Studies written in English, French, Italian, or Spanish will be considered. After screening the literature according to the inclusion and exclusion criteria, 2 independent reviewers will extract data and assess the risk of bias in eligible articles. This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. This protocol is registered in the Prospective Register of Ongoing Systematic Reviews (PROSPERO) CRD42023406380. DISCUSSION Chemotherapy-induced nausea and vomiting is a debilitating side effect that presents a significant challenge for patients with hematologic malignancies. Despite the publication of various guidelines, none of them include specific recommendations for each chemotherapy regimen. Therefore, analyzing the primary antiemetic prophylaxis regimens in patients with hematologic malignancies undergoing hematopoietic stem cell transplantation would be valuable in enhancing patients' quality of life.
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19
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Inui N, Toi Y, Yoneshima Y, Morise M, Hata A, Kubota K, Saeki T, Tamura T. Pooled Analysis of Studies Evaluating Fosnetupitant and Risk Factors for Cisplatin-Induced Nausea and Vomiting During the Extended Overall Phase. Adv Ther 2023; 40:4928-4944. [PMID: 37715851 PMCID: PMC10567891 DOI: 10.1007/s12325-023-02648-1] [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: 06/04/2023] [Accepted: 08/15/2023] [Indexed: 09/18/2023]
Abstract
INTRODUCTION Fosnetupitant is a novel neurokinin 1 receptor antagonist (NK1RA) with favorable antiemetic efficacy in patients receiving emetogenic chemotherapy. This study assessed the efficacy of fosnetupitant in combination with palonosetron and dexamethasone and identified risk factors for chemotherapy-induced nausea and vomiting (CINV) for up to 168 h after treatment using pooled data from Japanese studies. METHODS A pooled analysis of randomized phase II and phase III studies was performed to compare the efficacy of fosnetupitant and fosaprepitant in patients receiving cisplatin-based chemotherapy. The complete response (CR; no vomiting and no rescue medication) rate, CINV risk factors in various phases (0-120, 0-168, and 120-168 h), and impact of the number of risk factors on the time to treatment failure (TTF) were examined in the overall and NK1RA evaluable populations. RESULTS In the combined cohort of NK1RA evaluable patients (n = 980), the CR rate at 0-168 h was significantly better in the fosnetupitant 235 mg group than in the fosaprepitant group (rate difference = 6.8%, 95% confidence interval = 1.0-12.7, p = 0.022). In the overall (n = 1368) and NK1RA evaluable populations, the CINV risk factor at 120-168 h was treatment failure in the first 120 h. TTF deteriorated as the number of identified CINV risk factors increased. CONCLUSION This analysis revealed that fosnetupitant could have long-acting antiemetic potency (> 120 h) and indicated the importance of antiemetic therapy at 0-120 h for CINV up to 168 h after chemotherapy.
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Affiliation(s)
- Naoki Inui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Yukihiro Toi
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Yasuto Yoneshima
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masahiro Morise
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akito Hata
- Department of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tomohide Tamura
- Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
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20
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Schwartzberg L, Navari RM, Ruddy KJ, LeBlanc TW, Clark-Snow R, Wickham R, Kloth D, Binder G, Bailey WL, Turini M, Potluri R, Liu X, Papademetriou E, Roeland EJ. Work loss and activity impairment due to extended nausea and vomiting in patients with breast cancer receiving CINV prophylaxis. Support Care Cancer 2023; 31:654. [PMID: 37878086 PMCID: PMC10600031 DOI: 10.1007/s00520-023-08119-1] [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: 03/10/2023] [Accepted: 10/13/2023] [Indexed: 10/26/2023]
Abstract
PURPOSE Chemotherapy-induced nausea and vomiting (CINV)'s impact on work loss remains poorly described. We evaluated associations between the duration of CINV episodes, CINV-related work loss (CINV-WL), and CINV-related activity impairment (CINV-AI) in patients with breast cancer receiving highly emetogenic chemotherapy. METHODS We analyzed data from a prospective CINV prophylaxis trial of netupitant/palonestron and dexamethasone for patients receiving an anthracycline and cyclophosphamide (AC) for breast cancer (NCT0340371). Over the observed CINV duration (0-5 days), we analyzed patient-reported CINV-WL and CINV-AI for the first two chemotherapy cycles. We categorized patients as having either extended (≥ 3 days) or short (1-2 days) CINV duration and quantified its impact on work using the Work Productivity and Activity Impairment Questionnaire (WPAI). RESULTS Overall, we captured data for 792 cycles in 402 women, including 136 (33.8%) employed patients with 35.3% reporting CINV. Of those with CINV, patients reported CINV-WL in 26 cycles and CINV-AI in 142 cycles. Of those with CINV, 55.3% of extended CINV cycles experienced CINV-WL compared to 16.7% of short CINV cycles (p < 0.001). The relative risk of CINV-WL between extended and short CINV was 3.32 (p < 0.01) for employed patients. The mean difference in CINV-AI scores (higher = worse) between extended and short duration CINV was 5.0 vs. 3.0 (p < 0.001). CONCLUSION Extended (≥ 3 days) CINV was associated with more than triple the risk of CINV-WL and higher CINV-AI compared with short CINV.
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Affiliation(s)
| | | | | | - Thomas W LeBlanc
- Duke University School of Medicine, Duke Cancer Institute, Durham, NC, USA
| | | | - Rita Wickham
- Rush University College of Nursing, Chicago, IL, USA
| | | | | | | | | | | | - Xing Liu
- Putnam Associates, New York, NY, USA
| | | | - Eric J Roeland
- Oregon Health and Sciences Center, Knight Cancer Institute, Portland, OR, USA
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21
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Meena JP, Gupta AK, Jat KR, Anandani G, Sasidharan A, Tanwar P. Efficacy and Safety of Olanzapine for the Prevention of Chemotherapy-induced Nausea and Vomiting in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Pediatr Hematol Oncol 2023; 45:361-369. [PMID: 37539996 DOI: 10.1097/mph.0000000000002737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/25/2023] [Indexed: 08/05/2023]
Abstract
Chemotherapy-induced nausea and vomiting (CINV) remain the most distressing event in patients receiving highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC). This meta-analysis was conducted to evaluate the efficacy and safety of olanzapine containing regimen in preventing CINV in children on HEC and MEC. We searched PubMed, Embase, and Cochrane central register of controlled trials electronic databases to identify randomized clinical trials that compared 2 groups who either got olanzapine (olanzapine group) or placebo/no olanzapine (control group) for the prevention of CINV in children. The primary outcome was to determine the efficacy of olanzapine (complete response). The secondary outcomes were nausea control, the need for rescue medications, and adverse events of olanzapine. Three randomized clinical trials (n=394 patients) were included in this meta-analysis (olanzapine group, n=194, and placebo/control group, n=200). The pooled analysis of this meta-analysis found that olanzapine had a higher complete response in all phases of emesis in the HEC group and only in the acute phase in HEC/MEC groups compared with the control group. Olanzapine had higher nausea control in all phases of HEC but no nausea control in HEC/MEC. Olanzapine also reduced the need for rescue medications. A significant number of patients in the olanzapine group experienced somnolence (grades 1 and 2), but none of the participants discontinued the study due to side effects. In conclusion, this meta-analysis showed that olanzapine significantly prevented CINV in HEC. There was also a lesser need for rescue medications in the olanzapine group. Somnolence was higher in the olanzapine group, but it was clinically insignificant.
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Affiliation(s)
| | | | - Kana Ram Jat
- Laboratory Oncology Unit, Dr B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Anandani
- Department of Pathology, All India Institute of Medical Sciences
| | - Anju Sasidharan
- Department of Pathology, All India Institute of Medical Sciences
| | - Pranay Tanwar
- Laboratory Oncology Unit, Dr B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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22
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Liu F, Liao R, Cai J, Bu M, Xu N, Zhou J. Efficacy of press needle treatment in reducing chemotherapy-induced nausea, vomiting, and retching gastrointestinal cancer patients: A randomized controlled trial. Asia Pac J Oncol Nurs 2023; 10:100291. [PMID: 37766754 PMCID: PMC10520324 DOI: 10.1016/j.apjon.2023.100291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/01/2023] [Indexed: 09/29/2023] Open
Abstract
Objective Chemotherapy-induced nausea and vomiting (CINV) and retching often pose challenges in managing patients with gastrointestinal cancer. This randomized controlled trial sought to evaluate the effectiveness of press needle therapy in mitigating CINV and retching following chemotherapy. Methods Two hundred patients with gastrointestinal cancer undergoing folinic acid, fluorouracil, and oxaliplatin (FOLFOX) chemotherapy were randomly assigned to either the press needle group or the control group. The control group received 5-hydroxytryptamine-3 (5-HT3) antagonists and dexamethasone 30 min before chemotherapy, followed by dexamethasone on days 2 and 3 after chemotherapy. In contrast, the press needle group received press needle treatment 30 min prior to chemotherapy. The primary outcome was the Index of Nausea, Vomiting, and Retching (INVR), assessed at seven time points: before chemotherapy and at 12, 24, 36, 48, 60, and 72 h post-chemotherapy. Results All patients completed their respective treatments, and no significant adverse effects related to press needle treatment (such as skin allergies, acupoint infections, headaches, or dizziness) were reported. A two-way repeated-measures analysis of variance (ANOVA) revealed significant differences in INVR scores between the two groups (P < 0.05). Further analysis with a t-test indicated that INVR scores in the press needle treatment group were significantly lower than those in the control group at 12, 24, and 36 hours after chemotherapy (P < 0.05), with no significant difference observed thereafter. Conclusions Press needle treatment effectively alleviated nausea, vomiting, and retching in patients with gastrointestinal cancer undergoing chemotherapy. It represents a safe, efficient, and convenient complement to preventive treatment with 5-HT3 antagonists. Trial registration Chinese Clinical Trial Registry (No. ChiCTR1900024554).
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Affiliation(s)
- Fenyu Liu
- Nursing Department, Integrated Hospital of Traditional Chinse Medicine, Southern Medical University, Guangzhou, China
| | - Rongrong Liao
- Oncology Department, Integrated Hospital of Traditional Chinse Medicine, Southern Medical University, Guangzhou, China
| | - Jianhong Cai
- Oncology Department, Integrated Hospital of Traditional Chinse Medicine, Southern Medical University, Guangzhou, China
| | - Mengru Bu
- Nursing Department, Integrated Hospital of Traditional Chinse Medicine, Southern Medical University, Guangzhou, China
| | - Ningjun Xu
- Nursing Department, Integrated Hospital of Traditional Chinse Medicine, Southern Medical University, Guangzhou, China
| | - Jin Zhou
- Nursing Department, Integrated Hospital of Traditional Chinse Medicine, Southern Medical University, Guangzhou, China
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Sukpiriyagul A, Chartchaiyarerk R, Tabtipwon P, Smanchat B, Prommas S, Bhamarapravatana K, Suwannarurk K. Oral Tetrahydrocannabinol (THC):Cannabinoid (CBD) Cannabis Extract Adjuvant for Reducing Chemotherapy-Induced Nausea and Vomiting (CINV): A Randomized, Double-Blinded, Placebo-Controlled, Crossover Trial. Int J Womens Health 2023; 15:1345-1352. [PMID: 37608911 PMCID: PMC10440684 DOI: 10.2147/ijwh.s401938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 07/11/2023] [Indexed: 08/24/2023] Open
Abstract
Objective To evaluate the effects of tetrahydrocannabinol (THC):cannabinoid (CBD) (1:1) oil in reducing chemotherapy-induced nausea and vomiting (CINV) in gynecologic cancer patients who received moderate-to-high emetogenic chemotherapy. Material and Method This was a randomized, double-blinded, crossover and placebo-controlled trial. The study was conducted at the Gynecologic Oncology Units, Bhumibol Adulyadej Hospital (BAH), Royal Thai Air Force, Bangkok, Thailand, between August and November 2022. Participants had gynecologic cancer and received moderate-to-high emetogenic chemotherapy. Subjects were randomized and divided into two groups (A and B) based on the block of four randomization method. In the first cycle, groups A and B received THC:CBD extract oil 1:1 (TCEO) and placebo before chemotherapy administration. In the second cycle, groups A and B received placebo and TCEO before chemotherapy administration. Both groups received per protocol antiemetic medication during chemotherapy. Nausea score and side effects were recorded. Results A total of 60 cases were recruited. After exclusion, 54 cases were included in the study. The mean age of participants was 54.4 years. The mean body mass index (BMI) was 26.5 kg/m2. Fifty-nine (21/54) percent cases were the advanced stages of cancer. The nausea score of TCEO and placebo groups were 2.11 and 2.99, respectively (P < 0.05). More than half of the participants (36/54) reported dizziness and sedation side effects. Dry mouth, confusion, anxiety, and palpitation of both groups were comparable. Conclusion The cannabinoid extract (THC:CBD) was an appropriate adjuvant agent to reduce CINV in patients with gynecologic cancer who received high-emetogenic chemotherapy. Dizziness and sedation were the major side effects.
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Affiliation(s)
- Apichaya Sukpiriyagul
- Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air ForceBangkokThailand
| | - Ratiporn Chartchaiyarerk
- Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air ForceBangkokThailand
| | - Paluekpon Tabtipwon
- Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air ForceBangkokThailand
| | - Buppa Smanchat
- Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air ForceBangkokThailand
| | - Sinart Prommas
- Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air ForceBangkokThailand
| | - Kornkarn Bhamarapravatana
- Department of Preclinical Science, Faculty of Medicine, Thammasat University Hospital, Pathum Thani, Thailand
| | - Komsun Suwannarurk
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University Hospital, Pathum Thani, Thailand
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24
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Creanga-Murariu I, Filipiuc LE, Cuciureanu M, Tamba BI, Alexa-Stratulat T. Should oncologists trust cannabinoids? Front Pharmacol 2023; 14:1211506. [PMID: 37521486 PMCID: PMC10373070 DOI: 10.3389/fphar.2023.1211506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
Cannabis enjoyed a "golden age" as a medicinal product in the late 19th, early 20th century, but the increased risk of overdose and abuse led to its criminalization. However, the 21st century have witnessed a resurgence of interest and a large body of literature regarding the benefits of cannabinoids have emerged. As legalization and decriminalization have spread around the world, cancer patients are increasingly interested in the potential utility of cannabinoids. Although eager to discuss cannabis use with their oncologist, patients often find them to be reluctant, mainly because clinicians are still not convinced by the existing evidence-based data to guide their treatment plans. Physicians should prescribe cannabis only if a careful explanation can be provided and follow up response evaluation ensured, making it mandatory for them to be up to date with the positive and also negative aspects of the cannabis in the case of cancer patients. Consequently, this article aims to bring some clarifications to clinicians regarding the sometimes-confusing various nomenclature under which this plant is mentioned, current legislation and the existing evidence (both preclinical and clinical) for the utility of cannabinoids in cancer patients, for either palliation of the associated symptoms or even the potential antitumor effects that cannabinoids may have.
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Affiliation(s)
- Ioana Creanga-Murariu
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
- Oncology Department, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
| | - Leontina Elena Filipiuc
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
| | - Magda Cuciureanu
- Pharmacology Department, Clinical Pharmacology and Algesiology, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
| | - Bogdan-Ionel Tamba
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
- Pharmacology Department, Clinical Pharmacology and Algesiology, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
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25
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Navari RM, Nelson WW, Shoaib S, Singh R, Zhang W, Bailey WL. Real-World Treatment Outcomes, Healthcare Resource Use, and Costs Associated with Antiemetics Among Cancer Patients on Cisplatin-Based Chemotherapy. Adv Ther 2023; 40:3217-3226. [PMID: 37245189 PMCID: PMC10271895 DOI: 10.1007/s12325-023-02537-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/27/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Chemotherapy-induced nausea and vomiting (CINV) is a recognized adverse outcome among patients with cancer. This retrospective study aimed to quantify the treatment outcomes, resource utilization, and costs associated with antiemetic use to prevent CINV in a broad US population who received cisplatin-based chemotherapy. METHODS Data from the STATinMED RWD Insights Database was collected from January 1, 2015 to December 31, 2020. Cohorts included any patients that had at least one claim for fosnetupitant + palonosetron (NEPA) or fosaprepitant + palonosetron (APPA) and evidence of initiating cisplatin-based chemotherapy. Logistic regression was used to evaluate nausea and vomiting visits within 14 days after chemotherapy, and generalized linear models were used to examine all-cause and CINV-related healthcare resource utilization (HCRU) and costs. RESULTS NEPA was associated with significantly lower rates of nausea and vomiting visits after chemotherapy (p = 0.0001), including 86% greater odds of nausea and vomiting events for APPA during the second week after chemotherapy (odds ratio [OR] = 1.86; p = 0.0003). The mean numbers of all-cause inpatient visits (p = 0.0195) and CINV-related inpatient and outpatient visits were lower among NEPA patients (p < 0.0001). These differences corresponded to 57% of NEPA patients and 67% of APPA patients having one or more inpatient visits (p = 0.0002). All-cause outpatient costs and CINV-related inpatient costs were also significantly lower for NEPA (p < 0.0001). The mean number of all-cause outpatient visits, all-cause inpatient costs, and CINV-related outpatient costs was not significantly different between groups (p > 0.05). CONCLUSION In this retrospective study based on claims data, NEPA was associated with lower rates of nausea and vomiting and lower CINV-related HCRU and costs compared to APPA following cisplatin-based chemotherapy. These results complement clinical trial data and published economic models supporting the use of NEPA as a safe, effective, and cost-saving antiemetic for patients undergoing chemotherapy.
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Affiliation(s)
- Rudolph M Navari
- World Health Organization, 4518 Crown Point Lane, Mount Olive, AL, 35117, USA
| | - Winnie W Nelson
- Helsinn Therapeutics (U.S.), Inc., 200 Wood Avenue South, Suite 100, Iselin, NJ, 08830, USA.
| | - Sofia Shoaib
- STATinMED, LLC, 13101 Preston Road, Suite 110, #3395, Dallas, TX, 75240, USA
| | - Risho Singh
- STATinMED, LLC, 13101 Preston Road, Suite 110, #3395, Dallas, TX, 75240, USA
| | - Weiping Zhang
- STATinMED, LLC, 13101 Preston Road, Suite 110, #3395, Dallas, TX, 75240, USA
| | - William L Bailey
- Helsinn Therapeutics (U.S.), Inc., 200 Wood Avenue South, Suite 100, Iselin, NJ, 08830, USA
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26
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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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27
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Potential Role of Natural Antioxidant Products in Oncological Diseases. Antioxidants (Basel) 2023; 12:antiox12030704. [PMID: 36978952 PMCID: PMC10045077 DOI: 10.3390/antiox12030704] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023] Open
Abstract
Nutrition has a significant effect and a crucial role in disease prevention. Low consumption of fruit and vegetables and a sedentary lifestyle are closely related with the onset and development of many types of cancer. Recently, nutraceuticals have gained much attention in cancer research due to their pleiotropic effects and relatively non-toxic behavior. In fact, although in the past there have been conflicting results on the role of some antioxidant compounds as allies against cancer, numerous recent clinical studies highlight the efficacy of dietary phytochemicals in the prevention and treatment of cancer. However, further investigation is necessary to gain a deeper understanding of the potential anticancer capacities of dietary phytochemicals as well as the mechanisms of their action. Therefore, this review examined the current literature on the key properties of the bioactive components present in the diet, such as carotenoids, polyphenols, and antioxidant compounds, as well as their use in cancer therapy. The review focused on potential chemopreventive properties, evaluating their synergistic effects with anticancer drugs and, consequently, the side effects associated with current cancer treatments.
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28
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Araújo A, Tavares N, Faria AL, Gomes R, Mendonça JC, Parente B, Capela A, Barata F, Macedo A. Evaluation of Current Antiemetic Therapy Response in Patients Undergoing MEC or HEC Regimens in Portugal. Curr Oncol 2023; 30:1529-1537. [PMID: 36826078 PMCID: PMC9954894 DOI: 10.3390/curroncol30020117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/05/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
Chemotherapy-induced nausea and vomiting (CINV) negatively impact cancer patients' quality of life and treatment outcomes. This study evaluated the achievement of complete response to CINV prophylaxis during the first five days after chemotherapy in adult outpatient cancer clinics with solid malignant tumours receiving Moderate or Highly Emetogenic Chemotherapy (MEC or HEC) in Portugal. During the study, patients completed three evaluations, and nausea severity and CINV impact on patients' daily life was assessed. A complete response (no emetic episodes, no use of rescue antiemetic medication, and no more than mild nausea) was observed in 72% of the cycles (N = 161) throughout the five days after chemotherapy. Amongst the patient population, 25% classified their CINV episodes as severe. Though more than half of the patients achieved a complete response, suggesting that a therapeutic effort is being made to minimise this side effect, the overall scenario is barely optimistic. Significantly, new CINV-control measures in MEC/HEC patients should be adopted, specifically avoiding the single use of dexamethasone and 5-HT3 and raising awareness of using NK1-RAs. Thus, it is critical to improve CINV prophylactic treatment and implement practical international antiemetic guidelines in Portuguese clinical practice, envisaging the improvement of supportive care for cancer patients.
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Affiliation(s)
- António Araújo
- Hospital de Santo António, Centro Hospitalar Universitário do Porto, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal
- Correspondence:
| | - Nuno Tavares
- Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Ana Luísa Faria
- Centro Hospitalar de Entre-o-Douro e Vouga, E.P.E., 4520-211 Santa Maria da Feira, Portugal
| | - Rosa Gomes
- Centro Hospitalar de Trás-os-Montes e Alto Douro E.P.E., 5000 508 Vila Real, Portugal
| | | | | | - Andreia Capela
- Centro Hospitalar de Vila Nova de Gaia/Espinho, 4434-502 Vila Nova de Gaia, Portugal
- Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), 4410-406 Vila Nova de Gaia, Portugal
| | - Fernando Barata
- Centro Hospitalar Universitário de Coimbra, 3049-002 Coimbra, Portugal
| | - Ana Macedo
- Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, 8005-139 Faro, Portugal
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29
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Widgren Y, Silén M, Wåhlin I, Lindberg M, Fransson P, Efverman A. Chemotherapy-induced Emesis: Experienced Burden in Life, and Significance of Treatment Expectations and Communication in Chemotherapy Care. Integr Cancer Ther 2023; 22:15347354231217296. [PMID: 38098295 PMCID: PMC10725131 DOI: 10.1177/15347354231217296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/10/2023] [Accepted: 11/13/2020] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE Because antiemetics have become more effective and integrative therapies such as acupuncture are used in combination with antiemetics, people receiving chemotherapy for cancer today might expect less emesis than in the past. It is not previously described if and how people receiving modern antiemetics during chemotherapy experience emesis. The objective of this study was to describe experiences regarding emesis among persons undergoing emetogenic chemotherapy, and how it affects their quality of life, daily life and work. A further aim was to describe views on the significance of treatment expectations and communication with healthcare personnel while undergoing chemotherapy for cancer. METHOD Fifteen participants (median age 62 years, n = 1 man and n = 14 women, with breast (n = 13) or colorectal (n = 2) cancer) undergoing adjuvant or neo-adjuvant highly or moderately emetogenic chemotherapy were interviewed individually. The data were then analyzed using inductive thematic analysis. RESULTS Three themes described the participants' experiences: "Your whole life is affected, or continues as usual," covering descriptions of emesis limiting some participants' everyday lives, while others experienced no emesis at all or had found ways to manage it. Overall, participants described satisfaction with their antiemetic treatment. "Experiences and expectations more important than information", that is, the participants reported wanting all the information they could get about possible adverse effects of treatment, although they believed previous experiences were more important than information in creating expectations about treatment outcomes. The participants reported that being seen as a unique person was of utmost importance: "Meet me as I am." This creates trust in healthcare personnel and a feeling of safety and security in the situation. CONCLUSIONS These findings underline the importance of person-centered care and support in creating positive treatment expectations. Future research is called for regarding the potential antiemetic effects of positive communication regarding strengthening positive treatment expectations during emetogenic chemotherapy.
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Affiliation(s)
- Ylva Widgren
- University of Gävle, Gävle, Sweden
- Region Hospital of Sundsvall-Härnösand, County Council of Västernorrland, Sundsvall, Sweden
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30
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Patel P, Robinson PD, Cohen M, Devine K, Gibson P, Holdsworth MT, Neumann E, Orsey A, Phillips R, Spinelli D, Thackray J, van de Wetering M, Woods D, Cabral S, Sung L, Dupuis LL. Prevention of acute and delayed chemotherapy-induced nausea and vomiting in pediatric cancer patients: A clinical practice guideline. Pediatr Blood Cancer 2022; 69:e30001. [PMID: 36221901 DOI: 10.1002/pbc.30001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/11/2022]
Abstract
This clinical practice guideline provides recommendations for preventing acute and delayed phase chemotherapy-induced nausea and vomiting (CINV) in pediatric patients. The recommendations are based on two systematic reviews of randomized controlled trials evaluating interventions to prevent (1) acute phase CINV and (2) delayed phase CINV. Recommendations for acute phase and delayed phase CINV prophylaxis are made for patients receiving chemotherapy of varying emetogenicity, as well as for patients not able to receive dexamethasone or a neurokinin-1 receptor antagonist. Evidence gaps, including antiemetic safety and optimal dosing, were identified.
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Affiliation(s)
- Priya Patel
- Pediatric Oncology Group of Ontario, Toronto, Canada
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada
| | | | | | - Katie Devine
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Paul Gibson
- Pediatric Oncology Group of Ontario, Toronto, Canada
- Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Canada
| | - Mark T Holdsworth
- College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
| | - Eloise Neumann
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Andrea Orsey
- Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, Connecticut, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Robert Phillips
- Department of Haematology and Oncology, Leeds Teaching Hospital, NHS Trust, Leeds, UK
| | | | - Jennifer Thackray
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Deborah Woods
- University of California, Davis Health, Pediatric Hematology/Oncology, Davis, California, USA
| | - Sandra Cabral
- Pediatric Oncology Group of Ontario, Toronto, Canada
| | - Lillian Sung
- Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - L Lee Dupuis
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
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Patel P, Robinson PD, Wahib N, Cheung P, Wong T, Cabral S, Parker A, Cohen M, Devine K, Gibson P, Holdsworth MT, Neumann E, Orsey A, Phillips R, Spinelli D, Thackray J, van de Wetering M, Woods D, Sung L, Dupuis LL. Interventions for the prevention of acute phase chemotherapy-induced nausea and vomiting in adult and pediatric patients: a systematic review and meta-analysis. Support Care Cancer 2022; 30:8855-8869. [PMID: 35953731 PMCID: PMC10153509 DOI: 10.1007/s00520-022-07287-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/14/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE To identify effective and safe interventions to prevent acute phase chemotherapy-induced nausea and vomiting (CINV) in adult and pediatric patients. METHODS We conducted a systematic review of randomized trials evaluating interventions to prevent acute CINV. Outcomes assessed were complete chemotherapy-induced vomiting (CIV) control, complete chemotherapy-induced nausea (CIN) control, complete CINV control, and discontinuation of antiemetics due to adverse effects. RESULTS The search identified 65,172 citations; 744 were evaluated at full-text, and 295 (25 pediatric) met eligibility criteria. In patients receiving highly emetogenic chemotherapy (HEC), complete CIV (risk ratio (RR) 1.23, 95% confidence interval (CI) 1.05-1.44) and CIN (RR 1.34, 95% CI 1.10-1.62) control improved when olanzapine was added. The addition of a neurokinin-1 receptor antagonist (NK1RA) to a corticosteroid plus a serotonin-3 receptor antagonist (5HT3RA) also improved complete CIV (RR 1.11, 95% CI 1.08-1.14) and CIN (RR 1.05, 95% CI 1.01-1.08) control. Compared to granisetron/ondansetron, palonosetron provided improved complete CIV control when the 5HT3RA was given alone or when combined with dexamethasone. In patients receiving moderately emetogenic chemotherapy (MEC), dexamethasone plus a 5HT3RA improved complete CIV control compared to a 5HT3RA alone (RR 1.29, 95% CI 1.21-1.39). Only a single meta-analysis evaluating the safety outcome was possible. CONCLUSIONS For patients receiving HEC, various antiemetic regimens improved CIV and CIN control. For patients receiving MEC, administration of a 5HT3RA plus dexamethasone improved CIV control. Analysis of antiemetic safety was constrained by lack of data.
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Affiliation(s)
- Priya Patel
- Pediatric Oncology Group of Ontario, Toronto, Canada
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada
| | | | - Nora Wahib
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Patrick Cheung
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Thomas Wong
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Sandra Cabral
- Pediatric Oncology Group of Ontario, Toronto, Canada
| | | | | | - Katie Devine
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Paul Gibson
- Pediatric Oncology Group of Ontario, Toronto, Canada
- Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Canada
| | | | - Eloise Neumann
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Andrea Orsey
- Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, USA
| | - Robert Phillips
- Department of Haematology and Oncology, Leeds Teaching Hospital, NHS Trust, Leeds, UK
| | | | - Jennifer Thackray
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Deborah Woods
- Davis Health, Pediatric Hematology/Oncology, University of California, Davis, USA
| | - Lillian Sung
- Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - L Lee Dupuis
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada.
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
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Chen W, Zhao Y, Dai Y, Nie K. Gastrointestinal inflammation plays a critical role in chemotherapy-induced nausea and vomiting. Eur J Pharmacol 2022; 936:175379. [DOI: 10.1016/j.ejphar.2022.175379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
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Michnevich T, Pan Y, Hendi A, Oechsle K, Stein A, Nestoriuc Y. Preventing adverse events of chemotherapy for gastrointestinal cancer by educating patients about the nocebo effect: a randomized-controlled trial. BMC Cancer 2022; 22:1008. [PMID: 36138381 PMCID: PMC9502603 DOI: 10.1186/s12885-022-10089-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adverse events of chemotherapy may be caused by pharmacodynamics or psychological factors such as negative expectations, which constitute nocebo effects. In a randomized controlled trial, we examined whether educating patients about the nocebo effect is efficacious in reducing the intensity of self-reported adverse events. METHODS In this proof-of-concept study, N = 100 outpatients (mean age: 60.2 years, 65% male, 54% UICC tumour stage IV) starting first-line, de novo chemotherapy for gastrointestinal cancers were randomized 1:1 to a nocebo education (n = 49) or an attention control group (n = 51). Our primary outcome was patient-rated intensity of four chemotherapy-specific and three non-specific adverse events (rated on 11-point Likert scales) at 10-days and 12-weeks after the first course of chemotherapy. Secondary outcomes included perceived control of adverse events and tendency to misattribute symptoms. RESULTS General linear models indicated that intensity of adverse events differed at 12-weeks after the first course of chemotherapy (mean difference: 4.04, 95% CI [0.72, 7.36], p = .02, d = 0.48), with lower levels in the nocebo education group. This was attributable to less non-specific adverse events (mean difference: 0.39, 95% CI [0.04, 0.73], p = .03, d = 0.44) and a trend towards less specific adverse events in the nocebo education group (mean difference: 0.36, 95% CI [- 0.02, 0.74], p = .07, d = 0.37). We found no difference in adverse events at 10-days follow-up, perceived control of adverse events, or tendency to misattribute non-specific symptoms to the chemotherapy. CONCLUSIONS This study provides first proof-of-concept evidence for the efficacy of a brief information session in preventing adverse events of chemotherapy. However, results regarding patient-reported outcomes cannot rule out response biases. Informing patients about the nocebo effect may be an innovative and clinically feasible intervention for reducing the burden of adverse events. TRIAL REGISTRATION Retrospectively registered on March 27, 2018 to the German Clinical Trial Register (ID: DRKS00009501).
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Affiliation(s)
- T Michnevich
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Berlin, Germany.
- Present address: Charité - University Medicine Berlin, Berlin, Germany.
| | - Y Pan
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Hendi
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Oncology, Asklepios Clinic Barmbek, Hamburg, Germany
| | - K Oechsle
- Center of Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Stein
- Center of Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Y Nestoriuc
- Department of Clinical Psychology, Helmut Schmidt University, University of the Federal Armed Forces Hamburg, Hamburg, Germany
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Li G, Liu L, Yin Y, Wang M, Wang L, Dou J, Wu H, Yang Y, He B. Network pharmacology and experimental verification-based strategy to explore the underlying mechanism of Liu Jun An Wei formula in the treatment of gastrointestinal reactions caused by chemotherapy for colorectal cancer. Front Pharmacol 2022; 13:999115. [PMID: 36204230 PMCID: PMC9530632 DOI: 10.3389/fphar.2022.999115] [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] [Received: 07/20/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Liu Jun An Wei formula (LJAW), derived from “Liu Jun Zi Decoction”, is a classical prescription of Tradition Chinese Medicine and has been used for the treatment of gastrointestinal reactions caused by chemotherapy for colorectal cancer (CRC) for many years. Its molecular mechanism remains to be further explored.Objective: To clarify the mechanism of LJAW in attenuating gastrointestinal reactions caused by chemotherapy for CRC.Methods: The 5-fluorouracil (5-FU) induced mouse and intestine organoid models were established to observe the effect of LJAW. The ingredients of LJAW were analyzed and identified by UPLC-Q-TOF-MS technology. Targets of LJAW and chemotherapy-induced gastrointestinal reactions were collected from several databases. “Ingredient-target” network and protein-protein interaction network were constructed based on network pharmacology. Then, gene ontology (GO) functional analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed. Subsequently, molecular docking method was used to verify the interaction between the core ingredients and key targets. The results were validated by both in vivo experiments and organoid experiments. Western Blot was used to analyze the influence of LJAW on key targets including PI3K, AKT1, MAPK1, MAPK14 proteins and their phosphorylated proteins. RT-qPCR and Western Blot were used to detect the mRNA and protein levels of apoptosis-related gene PUMA.Results: Compared with the 5-FU group, the LJAW group had better morphology in mouse small intestine and intestine organoids. In total, 18 core ingredients and 19 key targets were obtained from 97 ingredients and 169 common targets. KEGG analysis showed that the common targets were involved in PI3K/Akt, MAPK, apoptosis and other signal pathways, which are closely related to gastrointestinal injury. Experiments confirmed that LJAW lowered the expressions of phosphorylated proteins including p-PI3K, p-AKT1, p-MAPK1, and p-MAPK14 and reduced the mRNA and protein levels of PUMA.Conclusion: LJAW shows protective effect on 5-FU induced small intestine and intestinal organoids injury. LJAW attenuates gastrointestinal reactions caused by chemotherapy for CRC probably by regulating apoptosis-related genes through PI3K/AKT and MAPK signaling pathways.
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Affiliation(s)
- Gaobiao Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Liying Liu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yiran Yin
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mengmeng Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lei Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jianwei Dou
- School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Hongwei Wu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yufei Yang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Yufei Yang, ; Bin He,
| | - Bin He
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Yufei Yang, ; Bin He,
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Merrow M, King N. Optimizing antiemetic therapy for children undergoing chemotherapy. J Pediatr Nurs 2022; 66:136-142. [PMID: 35759994 DOI: 10.1016/j.pedn.2022.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/30/2022] [Accepted: 06/11/2022] [Indexed: 11/25/2022]
Abstract
Chemotherapy-induced nausea and vomiting (CINV) is a common side effect of most chemotherapy agents. Suboptimal management of CINV impacts quality of life, nutrition, gastrointestinal (GI) integrity, and adherence to chemotherapy treatment plans. This article reviews the principles of CINV management, planning and implementation of antiemetic regimens, and pharmacology of the antiemetics currently available in the United States appropriate for pediatric use. With the advent of more targeted therapies, increased use of immunotherapy, and the effects of radiotherapy to the brain, spine, and abdomen, treatment of CINV now has a broader application than just for chemotherapeutics alone.
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Affiliation(s)
- Mya Merrow
- Department of Pharmacy, Children's Hospital Colorado, 13123 East 16(th) Avenue, Aurora, CO 80045, United States of America.
| | - Nancy King
- Department of Pediatrics, Center for Cancer and Blood Disorders, Children's Hospital Colorado, 13123 East 16(th) Avenue, Aurora, CO 80045, United States of America
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Di Mattei VE, Perego G, Taranto P, Mazzetti M, Rancoita PMV, Milano F, Mangili G, Rabaiotti E, Bergamini A, Cioffi R, Candiani M. Socio-demographic and psychological factors associated with quality of life of women undergoing chemotherapy treatment for gynecological cancer. Support Care Cancer 2022; 30:7333-7339. [PMID: 35608695 PMCID: PMC9385813 DOI: 10.1007/s00520-022-07162-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 05/17/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE This research aimed to investigate the socio-demographic, clinical, and psychological variables predictive of a greater functioning and quality of life in patients with gynecological cancer after their first cycle of carboplatin and taxol-based chemotherapy. METHODS The sample of the present research consisted of 104 patients. The European Organization on Research and Treatment of Cancer QLQ-C30, the State-Trait Anxiety Inventory-Form Y, and the Multidimensional Scale of Perceived Social Support were administered to each participant. RESULTS The analyses showed that higher state anxiety levels predicted a lower role, emotional, and social functioning and a lower general quality of life. Higher trait anxiety levels and social support perceived from one's friends predicted a greater role functioning. Similarly, having a relationship predicted a greater physical, cognitive, and social functioning. On the contrary, the presence of relapsed cancer was negatively associated with these patients' quality of life. CONCLUSIONS The present study highlighted the importance of identifying patients at higher risk of experiencing lower levels of functioning and worse general quality of life to implement tailored interventions from the beginning of treatment, thus improving the quality of life of these patients throughout the chemotherapy treatment.
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Affiliation(s)
- Valentina E Di Mattei
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gaia Perego
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy.
| | - Paola Taranto
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Martina Mazzetti
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola M V Rancoita
- University Centre for Statistics in the Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesca Milano
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuela Rabaiotti
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alice Bergamini
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaella Cioffi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Gebre D, Murugan R, Bizuwork K, Wurjine TH. Knowledge, practice and perceived barriers towards chemotherapy induced nausea and vomiting in prophylaxis guideline adherence among nurses in oncology units at selected hospitals, in Addis Ababa, Ethiopia, a cross-sectional study. BMC Nurs 2022; 21:223. [PMID: 35953790 PMCID: PMC9373462 DOI: 10.1186/s12912-022-01009-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
Background Chemotherapy-induced emesis can be prevented by the use of recommended guidelines for antiemetic regimens but a research study indicates that in Ethiopia the use of standard antiemetic drug guidelines is very limited. Objectives To assess knowledge, practice, and perceived barriers towards chemotherapy-induced nausea and vomiting in prophylaxis guideline adherence among nurses in oncology units. Methods A cross-sectional study design was conducted among 81 oncology nurses selected in the two public hospitals of Addis Ababa, from March 1 to 30, 2020. The study participants were selected by using the population census method from the source population of nurses in oncology units. Data has collected by using semi-structured questionnaires with the self-administrated method. Data were analyzed by using Statistical Package for the Social Sciences software version 24. Descriptive statistics and logistic regression including bivariate and multivariate were conducted to examine the association between independent and outcome variables. The level of significance was determined at a p-value < 0.05 and a 95% confidence interval. Result Seventy-nine nurses participated with a 96% of response rate. All participants were aged greater than 24 with a mean age of 28.8 ± 6 years and nearly two-thirds of the respondents (60.8%) were females. Nurses were not trained in chemotherapy-induced nausea and vomiting management shows 54.4%. nurses’ knowledge of chemotherapy-induced nausea and vomiting prophylaxis Guidelines was 78.5%. The means score of oncology nurses’ practice toward guideline recommendation was 41.8%. Knowledge of nurses associated with the use of chemotherapy-induced nausea and vomiting prophylaxis guideline recommendations working in the outpatient department, inpatient ward, and chemotherapy administration unit has a significant association with chemotherapy-induced nausea and vomiting management knowledge. In the multiple logistic regression analysis, nurses who have trained for chemotherapy-induced nausea and vomiting management were 1.64-fold more aware than those who were not trained. Conclusion The study reveals that nurses working in the oncology unit of the study hospitals have a poor practice of Chemotherapy-Induced Nausea and Vomiting. Therefore, recommended providing Training for the Nurses working in the oncology unit and encourage them to apply standard guidelines.
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Affiliation(s)
- Deneke Gebre
- AAU, CHS, School of Nursing and Midwifery, P.O. Box: 5657, Addis Ababa, Ethiopia
| | - Rajalakshmi Murugan
- AAU, CHS, School of Nursing and Midwifery, P.O. Box: 5657, Addis Ababa, Ethiopia
| | - Ketema Bizuwork
- AAU, CHS, School of Nursing and Midwifery, P.O. Box: 5657, Addis Ababa, Ethiopia
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Davidoff AJ, Akif K, Halpern MT. Research on the Economics of Cancer-Related Health Care: An Overview of the Review Literature. J Natl Cancer Inst Monogr 2022; 2022:12-20. [PMID: 35788372 DOI: 10.1093/jncimonographs/lgac011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/21/2022] [Indexed: 01/16/2023] Open
Abstract
We reviewed current literature reviews regarding economics of cancer-related health care to identify focus areas and gaps. We searched PubMed for systematic and other reviews with the Medical Subject Headings "neoplasms" and "economics" published between January 1, 2010, and April 1, 2020, identifying 164 reviews. Review characteristics were abstracted and described. The majority (70.7%) of reviews focused on cost-effectiveness or cost-utility analyses. Few reviews addressed other types of cancer health economic studies. More than two-thirds of the reviews examined cancer treatments, followed by screening (15.9%) and survivorship or end-of-life (13.4%). The plurality of reviews (28.7%) cut across cancer site, followed by breast (20.7%), colorectal (11.6%), and gynecologic (8.5%) cancers. Specific topics addressed cancer screening modalities, novel therapies, pain management, or exercise interventions during survivorship. The results indicate that reviews do not regularly cover other phases of care or topics including financial hardship, policy, and measurement and methods.
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Affiliation(s)
- Amy J Davidoff
- Healthcare Assessment Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Kaitlin Akif
- Office of the Associate Director, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Michael T Halpern
- Healthcare Assessment Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Li Y, Sun Y, Liu B, Sun Y, Chen P, Xie K, Wang Y, Zhu J. Prolonged administration of aprepitant improves cisplatin-based chemotherapy-induced nausea and vomiting. Future Oncol 2022; 18:2533-2543. [PMID: 35587019 DOI: 10.2217/fon-2021-1523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Aims: To determine the antiemetic efficacy of a 6-day aprepitant schedule in patients receiving multiple-day cisplatin. Patients & methods: Patients diagnosed with lung cancer and who were chemotherapy naive were screened. The patients willing to use aprepitant were randomly divided into two groups: prolonged use of aprepitant (PA; 6-day aprepitant) and standard use of aprepitant (SA; 3-day aprepitant); the patients who rejected aprepitant were recruited into the control group (group C). Primary end points included the safety and the number of days without chemotherapy-induced nausea and vomiting. Results: There was no statistical difference in adverse events among the three groups. The average days without chemotherapy-induced nausea and vomiting of group PA (18.28 ± 3.35) was significantly longer than in groups SA and C. Furthermore, better life function scores were achieved in group PA according to the Functional Living Index - Emesis questionnaire. Conclusion: In this study 6-day aprepitant was safe and more effective than standard 3-day aprepitant in controlling chemotherapy-induced nausea and vomiting due to 3-day cisplatin regimens.
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Affiliation(s)
- Yanying Li
- Department of Thoracic Oncology, West China Hospital of Sichuan University, Chengdu, China
| | - Yu Sun
- Department of Radiotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Liu
- Department of Thoracic Oncology, Sichuan Provincial Cancer Hospital, Chengdu, China
| | - Yi Sun
- Department of Oncology & Hematology, The 452nd Hospital of PLA, Chengdu, China
| | - Ping Chen
- The Center of Lung Cancer, No.7 People's Hospital of Chengdu, Chengdu, China
| | - Ke Xie
- Department of Oncology, The People's Hospital of Sichuan Province, Chengdu, China
| | - Yan Wang
- Department of IVF, West China Second Hospital of Sichuan University, Chengdu, China
| | - Jiang Zhu
- Department of Thoracic Oncology, West China Hospital of Sichuan University, Chengdu, China
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Was H, Borkowska A, Bagues A, Tu L, Liu JYH, Lu Z, Rudd JA, Nurgali K, Abalo R. Mechanisms of Chemotherapy-Induced Neurotoxicity. Front Pharmacol 2022; 13:750507. [PMID: 35418856 PMCID: PMC8996259 DOI: 10.3389/fphar.2022.750507] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/02/2022] [Indexed: 12/15/2022] Open
Abstract
Since the first clinical trials conducted after World War II, chemotherapeutic drugs have been extensively used in the clinic as the main cancer treatment either alone or as an adjuvant therapy before and after surgery. Although the use of chemotherapeutic drugs improved the survival of cancer patients, these drugs are notorious for causing many severe side effects that significantly reduce the efficacy of anti-cancer treatment and patients’ quality of life. Many widely used chemotherapy drugs including platinum-based agents, taxanes, vinca alkaloids, proteasome inhibitors, and thalidomide analogs may cause direct and indirect neurotoxicity. In this review we discuss the main effects of chemotherapy on the peripheral and central nervous systems, including neuropathic pain, chemobrain, enteric neuropathy, as well as nausea and emesis. Understanding mechanisms involved in chemotherapy-induced neurotoxicity is crucial for the development of drugs that can protect the nervous system, reduce symptoms experienced by millions of patients, and improve the outcome of the treatment and patients’ quality of life.
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Affiliation(s)
- Halina Was
- Laboratory of Molecular Oncology and Innovative Therapies, Military Institute of Medicine, Warsaw, Poland
| | - Agata Borkowska
- Laboratory of Molecular Oncology and Innovative Therapies, Military Institute of Medicine, Warsaw, Poland.,Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Ana Bagues
- Área de Farmacología y Nutrición, Departamento de Ciencias Básicas de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain.,High Performance Research Group in Experimental Pharmacology (PHARMAKOM-URJC), URJC, Alcorcón, Spain.,Unidad Asociada I+D+i del Instituto de Química Médica (IQM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Longlong Tu
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Julia Y H Liu
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Zengbing Lu
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - John A Rudd
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,The Laboratory Animal Services Centre, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Kulmira Nurgali
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.,Department of Medicine Western Health, University of Melbourne, Melbourne, VIC, Australia.,Regenerative Medicine and Stem Cells Program, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, VIC, Australia
| | - Raquel Abalo
- Área de Farmacología y Nutrición, Departamento de Ciencias Básicas de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain.,Unidad Asociada I+D+i del Instituto de Química Médica (IQM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain.,High Performance Research Group in Physiopathology and Pharmacology of the Digestive System (NeuGut-URJC), URJC, Alcorcón, Spain.,Grupo de Trabajo de Ciencias Básicas en Dolor y Analgesia de la Sociedad Española del Dolor, Madrid, Spain
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del Pozo-Rubio R, Ortega-Ortega M. Sociodemographic and health factors associated with the risk of financial catastrophe when informal care for patients with haematological neoplasms is replaced by formal care. HEALTH ECONOMICS REVIEW 2022; 12:20. [PMID: 35266072 PMCID: PMC8908606 DOI: 10.1186/s13561-022-00364-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/24/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cancer is one of the diseases with the highest incidence and mortality in the world, and one that requires greater care (formal and informal). At present, the traditional informal caregiver is disappearing. The objective is to analyse the sociodemographic and health factors associated with the possible catastrophic financial effect on households of replacing informal care by formal care for patients with blood cancer, during the different stages of treatment in Spain. METHODS A total of 139 patients with haematological neoplasm who underwent stem cell transplantation completed a longitudinal questionnaire during each of three treatment phases. Of this population, 88.49% received informal care. The households were classified into those where the replacement of informal care with formal care would impose a financial burden exceeding 40% of equivalent household income, versus those who would not suffer this consequence. Three logistic regression models (one for each treatment phase) were estimated and the corresponding marginal effects determined. RESULTS The factors associated with a higher probability of financial catastrophe were married marital status, low education level, fair to very poor self-perceived health status, the diagnosis of leukaemia in the pre-transplant and first-year post-transplant phases and of multiple myeloma disease in the final post-transplant phase. CONCLUSIONS These findings reveal the need to design social policies to meet the care needs of patients with blood cancer which at present are covered by informal care. Given the foreseeable elimination of this option, these families must be protected from the financial burden incurred from the use of privately-contracted assistance.
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Affiliation(s)
- Raúl del Pozo-Rubio
- Department of Economics and Finance, Faculty of Social Sciences, University of Castilla-La Mancha, Avenida de los Alfares, 44. C.P.: 16.071, Cuenca, Spain
| | - Marta Ortega-Ortega
- Department of Applied and Public Economics, and Political Economy, Complutense University of Madrid, Campus de Somosaguas s/n. 28.023, Madrid, Pozuelo de Alarcón, Spain
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Crowder SL, Hoogland AI, Welniak TL, LaFranchise EA, Carpenter KM, Li D, Rotroff DM, Mariam A, Pierce CM, Extermann M, Kim RD, Tometich DB, Figueiredo JC, Muzaffar J, Bari S, Turner K, Weinstock GM, Jim HS. Metagenomics and chemotherapy-induced nausea: A roadmap for future research. Cancer 2022; 128:461-470. [PMID: 34643945 PMCID: PMC8776572 DOI: 10.1002/cncr.33892] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/06/2021] [Accepted: 08/13/2021] [Indexed: 02/03/2023]
Abstract
Uncontrolled chemotherapy-induced nausea and vomiting can reduce patients' quality of life and may result in premature discontinuation of chemotherapy. Although nausea and vomiting are commonly grouped together, research has shown that antiemetics are clinically effective against chemotherapy-induced vomiting (CIV) but less so against chemotherapy-induced nausea (CIN). Nausea remains a problem for up to 68% of patients who are prescribed guideline-consistent antiemetics. Despite the high prevalence of CIN, relatively little is known regarding its etiology independent of CIV. This review summarizes a metagenomics approach to the study and treatment of CIN with the goal of encouraging future research. Metagenomics focuses on genetic risk factors and encompasses both human (ie, host) and gut microbial genetic variation. Little work to date has focused on metagenomics as a putative biological mechanism of CIN. Metagenomics has the potential to be a powerful tool in advancing scientific understanding of CIN by identifying new biological pathways and intervention targets. The investigation of metagenomics in the context of well-established demographic, clinical, and patient-reported risk factors may help to identify patients at risk and facilitate the prevention and management of CIN.
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Affiliation(s)
| | | | | | | | | | - Daneng Li
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center
| | - Daniel M. Rotroff
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Arshiya Mariam
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | | | - Richard D. Kim
- Department of Hematology Oncology, Moffitt Cancer Center
| | | | | | - Jameel Muzaffar
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center
| | - Shahla Bari
- Department of Hematology Oncology, Moffitt Cancer Center
| | - Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center
| | | | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center
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Zeng C, Chen H, Xu Y, Ji H, Du N, Song X, Hou L. Risk factors for chemotherapy-induced vomiting after general anesthesia in children with retinoblastoma: a retrospective study. Transl Pediatr 2021; 10:3005-3013. [PMID: 34976766 PMCID: PMC8649612 DOI: 10.21037/tp-21-245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The chemotherapy-induced vomiting (CIV) severely affects the daily function, nutritional status, treatment compliance, therapeutic efficacy, curability, and the quality of life of patients. The aim of this study was to find the risk factors for CIV after general anesthesia in patients with retinoblastoma (RB). METHODS A retrospective review of the hospital records of children with RB, who underwent chemotherapy between January 2017 and December 2019, was conducted at our hospital. RESULTS Data of a total of 803 children with RB were reviewed. The incidence of CIV in children with RB was 19.30%. Univariate analysis showed statistically significant differences in age, height, weight, chemotherapy regimen, anesthesia dose, duration of surgery and general anesthesia, platelet count, platelet distribution width, lymphocytes, and indirect bilirubin between patients with and without vomiting (P<0.05). Multivariate logistic regression analysis showed that the main predictors of CIV in children with RB included older age [odds ratio (OR), 1.32; 95% confidence interval (CI): 1.11-1.56; P<0.01], low platelet count (OR, 0.997; 95% CI: 0.995-0.999; P<0.05), and chemotherapy regimen (intravenous chemotherapy versus intra-arterial chemotherapy; OR, 0.47; 95% CI: 0.29-0.76; P<0.01). CONCLUSIONS This study revealed age, chemotherapy regimen, and platelet count as risk factors of CIV after general anesthesia in children with RB. Younger age and higher platelet count were protective factors for CIV. Compared with intravenous chemotherapy, the incidence of CIV was lower than that of intra-arterial chemotherapy. Although these factors cannot be modified, they can predict whether a patient may experience vomiting, assisting medical staff to formulate measures and intervenes in advance. KEYWORDS Retinoblastoma (RB); chemotherapy-induced vomiting (CIV); general anesthesia; multivariate analysis; risk factors.
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Affiliation(s)
- Changjuan Zeng
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Jiao Tong University, School of Nursing, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Huifang Chen
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yanjuan Xu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Hong Ji
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Na Du
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Xuefei Song
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Lili Hou
- Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Jin Y, Li X, Jiang C, Zhao J, Liu G, Li H, Jin G, Li Q. An Update in Our Understanding of the Relationships Between Gene Polymorphisms and Chemotherapy-Induced Nausea and Vomiting. Int J Gen Med 2021; 14:5879-5892. [PMID: 34566427 PMCID: PMC8458022 DOI: 10.2147/ijgm.s329257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/01/2021] [Indexed: 11/23/2022] Open
Abstract
The occurrence and severity of chemotherapy-induced nausea and vomiting (CINV) are influenced by many factors; this includes therapeutic factors, such as the dose, administration mode, and chemotherapeutic agent emetogenicity, as well as patient-related risk factors, such as the gender, age, alcohol consumption history, and anxiety level. However, these factors cannot fully explain the individual CINV differences. In recent years, the correlation between gene polymorphism and CINV has been a hot research topic; the present paper reviews current research on CINV-related gene polymorphisms, and the results indicate that the use of gene polymorphism for the optimization of CINV efficacy is of important clinical significance.
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Affiliation(s)
- Yilan Jin
- Department of Medical Oncology, Ordos Central Hospital, Ordos, 017000, People's Republic of China
| | - Xiaorong Li
- Department of Medical Oncology, Ordos Central Hospital, Ordos, 017000, People's Republic of China
| | - Caihong Jiang
- Department of Medical Oncology, Ordos Central Hospital, Ordos, 017000, People's Republic of China
| | - Jun Zhao
- Department of Medical Oncology, Ordos Central Hospital, Ordos, 017000, People's Republic of China
| | - Guang Liu
- Department of Medical Oncology, Ordos Central Hospital, Ordos, 017000, People's Republic of China
| | - Hui Li
- Department of Medical Oncology, Ordos Central Hospital, Ordos, 017000, People's Republic of China
| | - Gaowa Jin
- Department of Medical Oncology, Ordos Central Hospital, Ordos, 017000, People's Republic of China
| | - Quanfu Li
- Department of Medical Oncology, Ordos Central Hospital, Ordos, 017000, People's Republic of China
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Zhou JG, Huang L, Jin SH, Xu C, Frey B, Ma H, Gaipl US. Olanzapine combined with 5-hydroxytryptamine type 3 receptor antagonist (5-HT3 RA) plus dexamethasone for prevention and treatment of chemotherapy-induced nausea and vomiting in high and moderate emetogenic chemotherapy: a systematic review and meta-analysis of randomised controlled trials. ESMO Open 2021; 5:S2059-7029(20)30018-1. [PMID: 32079622 PMCID: PMC7046384 DOI: 10.1136/esmoopen-2019-000621] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/03/2019] [Accepted: 12/29/2019] [Indexed: 01/30/2023] Open
Abstract
We performed a pooled analysis to evaluate the efficacy and adverse events (AEs) of olanzapine combined with dexamethasone plus 5-hydroxytryptamine type 3 receptor antagonist (5-HT3 RA) compared with 5-HT3 RA plus dexamethasone for the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in high and moderate emetogenic chemotherapy based on randomised controlled trials (RCTs). PubMed, EMBASE, Web of Science, the Cochrane Library, China Biomedical Literature database (CBM), WanFang Database, China National Knowledge Infrastructure (CNKI), and Chinese Science and Technology Periodical Database (VIP) (from their inception to April 2019) were searched to capture relevant articles. Relative risk with 95% confidence intervals for CINV and AEs were all extracted or calculated. Eleven studies with 1107 cancer patients were involved in this review. The pooled RR of delayed CINV (RR 0.50, 95% CI 0.38 to 0.66; p<0.01) were significantly decreased in the olanzapine group. The occurrence of insomnia was also statistically decreased, as was the rate of acute CINV (RR 0.60, 95% CI 0.48 to 0.75; p<0.01). However, only the percentages of CINV III and CINV IV were significantly decreased in the acute and delayed phases. Subgroup analysis demonstrated that the efficacy was not statistically significantly different between 5 mg and 10 mg olanzapine. Olanzapine significantly decreased the occurrence of CINV III and IV and insomnia in high and moderately emetogenic chemotherapy. Compared with 10 mg per day, 5 mg oral olanzapine may be more appropriate for patients with cancer.
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Affiliation(s)
- Jian-Guo Zhou
- Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Lang Huang
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, China
| | - Su-Han Jin
- Department of Orthodontics, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China
| | - Cheng Xu
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, China
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Hu Ma
- Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany
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Prevention of chemotherapy-induced nausea and vomiting in the real-world setting in Spain. Clin Transl Oncol 2021; 23:2155-2162. [PMID: 33956310 PMCID: PMC8390393 DOI: 10.1007/s12094-021-02623-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/07/2021] [Indexed: 02/08/2023]
Abstract
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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Lordick F, Al-Batran SE, Ganguli A, Morlock R, Sahin U, Türeci Ö. Patient-reported outcomes from the phase II FAST trial of zolbetuximab plus EOX compared to EOX alone as first-line treatment of patients with metastatic CLDN18.2+ gastroesophageal adenocarcinoma. Gastric Cancer 2021; 24:721-730. [PMID: 33755863 PMCID: PMC8064997 DOI: 10.1007/s10120-020-01153-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Zolbetuximab plus first-line EOX (epirubicin, oxaliplatin, capecitabine; ZOL/EOX) significantly prolonged progression-free survival and overall survival in the FAST trial vs EOX alone. We report the patient-reported outcomes (PROs) of FAST in patients with advanced gastroesophageal adenocarcinoma. METHODS Patients were randomized to ZOL/EOX or EOX alone. Patients could receive ≤ 8 EOX cycles and remained on zolbetuximab until disease progression. PROs were collected using the EORTC QLQ-C30 and QLQ-STO22 before drug administration at day 1/cycle 1, day 1/cycle 5, end of EOX treatment, and q12w thereafter until disease progression. Time to deterioration (TTD), defined as the first meaningful worsening from baseline, in the individual QLQ-C30/QLQ-STO22 scores was analyzed. Longitudinal changes in scores from baseline were analyzed using a mixed-effects model for repeated measures (MMRM). RESULTS The per protocol population included 143 (ZOL/EOX: 69; EOX: 74) patients. Baseline QLQ-C30 and STO22 scores were comparable between arms and denoted intermediate-to-high quality of life (QoL), intermediate-to-low global health status (GHS) and low symptom burden. Descriptive analyses showed no differences between arms until end of EOX but maintenance therapy with zolbetuximab was associated with better QoL and less symptom burden thereafter. TTD for most scores favored ZOL/EOX over EOX and reached statistical significance for GHS (p = 0.008). MMRM results support TTD findings; no statistically significant differences were observed between arms in any score except for nausea and vomiting (p = 0.0181 favoring EOX). CONCLUSIONS ZOL/EOX allowed patients to maintain good QoL and low symptom burden for longer than EOX alone.
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Affiliation(s)
- Florian Lordick
- University of Leipzig Medical Center, University Cancer Center (UCCL), Leipzig, Germany.
| | - Salah-Eddin Al-Batran
- Institut für Klinische Krebsforschung IKF Am Krankenhaus Nordwest, Frankfurt, Germany
| | | | | | - Ugur Sahin
- TRON - Translational Oncology at the University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Biopharmaceutical New Technologies (BioNTech) Corporation, Mainz, Germany
| | - Özlem Türeci
- Biopharmaceutical New Technologies (BioNTech) Corporation, Mainz, Germany
- CI3 - Cluster of Individualized Immune Intervention; formerly of Ganymed Pharmaceuticals GmbH, Mainz, Germany
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Chen L, Wu X, Chen X, Zhou C. Efficacy of Auricular Acupressure in Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting in Patients with Cancer: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:8868720. [PMID: 34394394 PMCID: PMC8357499 DOI: 10.1155/2021/8868720] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 06/14/2021] [Accepted: 07/22/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND More than 40% of patients with cancer have reported that chemotherapy-induced nausea and vomiting (CINV) remained the most debilitating side effects of treatment even in the era of new antiemetics. OBJECTIVE The purpose of this review was to systematically evaluate the clinical effect of auricular acupressure (AA) in prevention and treatment of chemotherapy-induced nausea and vomiting. METHODS The following databases were searched: PubMed, Cochrane Library, EMBASE, the Web of Science, Chinese Biological Medicine (CBM), Chinese National Knowledge Infrastructure (CNKI), Wanfang, and VIP (from database inception to April 2020). Eligible randomized controlled trials of auricular acupressure in treating CINV were collected, including crossover randomized design study. The meta-analysis was carried out by RevMan software (5.3). RESULTS Totally 19 RCTs with 1449 patients met the inclusion criteria. Compared with control groups, the relief efficiency of overall CINV was enhanced by AA combined with antiemetics (RR = 1.31, CI 1.22 to 1.41, p ≤ 0.001). Although the therapeutic effect on acute nausea and vomiting was not obvious, AA still played an important role in reducing delayed nausea and vomiting (delayed nausea frequency: RR = 0.68, CI -1.01 to -1.35, p ≤ 0.001; delayed vomiting frequency: RR = 0.91, CI -1.22 to -0.61, p ≤ 0.001). The likelihood of adverse reactions related to antiemetics was reduced by AA combined with antiemetics (RR = 0.62, CI 0.53 to 0.74, p ≤ 0.001). Statistically significant association was found between AA and incidence of constipation, diarrhea, and tiredness, while there was no statistically significant association between AA and abdominal distension or headache. CONCLUSION Auricular acupressure supplementation benefited delayed chemotherapy-induced nausea and vomiting as well as constipation, diarrhea, and tiredness. AA alone or AA supplementation has little effect on acute nausea and acute vomiting. There is no conclusion on whether AA alone is superior to antiemetics in the management of delayed CINV. Further studies are needed to confirm the efficacy of auricular acupressure alone in delayed CINV and anticipatory CINV. The results of this review provided the basis for further research with more rigorous study designs, adequate sample sizes, and standardized implementation to confirm the efficacy of auricular acupressure.
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Affiliation(s)
- Lichan Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Xiaohong Wu
- Shantou University Medical College, Shantou, China
| | - Xisui Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Chunjiao Zhou
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Methodology Aspects of Nausea Measuring During Pelvic Radiotherapy: Daily Nausea Measuring Is Successful to Identify Patients Experiencing Nausea. Cancer Nurs 2020; 43:93-104. [PMID: 32106172 DOI: 10.1097/ncc.0000000000000684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nausea seems underreported during pelvic radiotherapy. OBJECTIVE The aims of this study were to investigate if a 5-week recall measure of nausea covering the entire radiotherapy period was comparable with accumulated daily nausea measurements and to investigate if the measuring method affected potential difference in quality of life (QoL) between nauseated patients and patients free from nausea. METHODS This longitudinal methodology study covered 200 patients (mean age, 64 years; 84% women; 69% had gynecological cancer). The patients graded QoL (Functional Assessment of Cancer Therapy-General). They registered nausea daily and at a 5-week recall at the end of radiotherapy. RESULTS The nausea-intensity category scale and visual analog scale correlated well (Spearman correlation coefficient = 0.622). According to the 5-week recall, 57 of 157 answering patients (36%) experienced nausea during the radiotherapy period. Using the daily nausea measurements, 94 of 157 patients (60%) experienced nausea (relative risk, 1.65; 95% confidence interval, 1.29-2.10). Of these 94 nauseated patients, 39 (42%) did not report nausea using the 5-week recall. The nauseated patients experienced worse QoL (physical/functional subscores) than patients free from nausea whether nausea was registered daily or at the 5-week recall. CONCLUSIONS Almost half, 42%, of the patients who experienced nausea according to daily nausea measurements did not report having had nausea according to the 5-week recall. Nauseated patients graded worse QoL than patients who were free from nausea. IMPLICATIONS FOR PRACTICE Nursing professionals should measure nausea repeatedly to identify patients at risk of nausea and worsened QoL, to be able to deliver evidence-based antiemetic treatment strategies.
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